Adverse social determinants and risk for congenital anomalies.

PAWLUK MS, CAMPAÑA H, GILI JA, COMAS B, GIMÉNEZ LG, VILLALBA MI, SCALA SC, POLETTA FA, LÓPEZ CAMELO JS.

ARCHIVOS ARGENTINOS DE PEDIATRIA

SOC ARGENTINA PEDIATRIA

Lugar: Buenos Aires; Año: 2014 vol. 112 p. 215 - 223

0325-0075

ABSTRACTIntroduction.Different studies have related familiar andregional adverse social conditions to perinatal outcome (neonatal mortality, low birth weightand  prematurity); however, few studieshave studied the  effect of poverty oncongenital anomalies.Objective.To assess the hazard ratio of  25 congenital anomalies and adverse social  determinants as per the socioeconomic level offamilies and regions.Population and methods.Exploratory, case-control study using datafrom the Latin-American  CollaborativeStudy of Congenital Malformations  . EstudioColaborativo Latinoamericano de Malformaciones Congénitas , ECLAMC). The sample consisted of3786  live newborn infants with a singlemalformation  and 13 344 controlsselected among 546 129 births  occurredin 39 hospitals from Argentina in the 1992-2001 period. Both direct andindirect (residence) risks (OR) were estimated, together with the interactionbetween the individual and residential socioeconomic levels for each of the 25 congenital anomalies.Results.Cleft lip with/without cleft palate  (OR= 1.43) and ventricular septal defect  (OR=1.38) showed a significantly higher riskin the lower socioeconomic level. Low socioeconomic levels were significantlyassociated with a higher frequency of parental  sibship (blood relationship), native descent,maternal age younger than 19 years old, more  than four pregnancies, a low number ofantenatal  care visits, and residence indeprived regions.Conclusion.Cleft lip with/without cleft palate andventricular septal defects were significantly associated with a lowersocioeconomic level. Lack of family planning and antenatal care, and exposureto environmental or teratogenic agents may account for these findings.Key words: congenital anomalies,inequities, cleft