TY - JOUR
T1 - Pre-Zika descriptive epidemiology of microcephaly in Texas, 2008–2012
AU - Hoyt, Adrienne T.
AU - Canfield, Mark A.
AU - Langlois, Peter H.
AU - Waller, Dorothy K.
AU - Agopian, A. J.
AU - Shumate, Charles J.
AU - Hall, Noemi B.
AU - Marengo, Lisa K.
AU - Ethen, Mary K.
AU - Scheuerle, Angela E.
N1 - Funding Information:
This analysis was supported in part through a cooperative agreement (CDC- RFA-DD16-1605) from the Centers for Disease Control and Prevention to the Texas Department of State Health Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the CDC. Work was also supported in part by Title V Maternal and Child Health Block Grant Funds from the Office of Title V and Family Health, Texas Department of State Health Services, and by general revenue from the State of Texas.
Funding Information:
This publication was supported in part through a cooperative agreement from the Centers for Disease Control and Prevention to the Texas Department of State Health Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the CDC. Work was also supported in part by the Title V Maternal and Child Health Block Grant Funds from the Office of Title V and Family Health, Texas Department of State Health Services, and by general revenue from the State of Texas. We thank Mr. Shady Al-Sayyed who assisted with preparing the manuscript for journal submission. The authors are also grateful for the hard work done by the staff of the Texas Birth Defects Epidemiology and Surveillance Branch in collecting the data for the Texas Birth Defects Registry.
Publisher Copyright:
© 2017 Wiley Periodicals, Inc
PY - 2018/3/15
Y1 - 2018/3/15
N2 - Background: There are limited population-based studies on microcephaly. We characterized the epidemiology of microcephaly in Texas during a 5-year period (2008–2012), prior to the Zika epidemic in the Western hemisphere (2015). The associations of suspected risk factors were compared across four clearly defined case groups. Methods: Data from the Texas Birth Defects Registry were used to calculate the prevalence of congenital microcephaly and crude and adjusted prevalence ratios using Poisson regression. Twelve maternal and infant factors were assessed across case groups, which included total (explained + unexplained), explained (e.g., syndromic), unexplained, and severe unexplained microcephaly (head circumference <3rd percentile). Results: The birth prevalence for total and total severe microcephaly were 14.7 and 4.8 per 10,000 livebirths, respectively. For explained and unexplained cases, significantly elevated risks were noted for mothers who were older (35+), less educated (≤12 years), diabetic (pre-pregnancy or gestational), or had a preterm delivery. Unlike explained cases, however, mothers who were non-White or smoked had an increased risk for unexplained microcephaly. Furthermore, young maternal age (<20), multiparity, and higher BMI reduced the risk for unexplained microcephaly. For severe unexplained cases, the risk profile was similar to that for all unexplained cases—with the exception of null associations noted for diabetes and birth year. Conclusions: We found that risk patterns for microcephaly varied across case groupings. Risk factors included maternal race/ethnicity, age, and smoking during pregnancy. Among severe unexplained cases, notable positive associations were seen among mothers who were non-Hispanic Black or less educated, while inverse associations were noted for obesity.
AB - Background: There are limited population-based studies on microcephaly. We characterized the epidemiology of microcephaly in Texas during a 5-year period (2008–2012), prior to the Zika epidemic in the Western hemisphere (2015). The associations of suspected risk factors were compared across four clearly defined case groups. Methods: Data from the Texas Birth Defects Registry were used to calculate the prevalence of congenital microcephaly and crude and adjusted prevalence ratios using Poisson regression. Twelve maternal and infant factors were assessed across case groups, which included total (explained + unexplained), explained (e.g., syndromic), unexplained, and severe unexplained microcephaly (head circumference <3rd percentile). Results: The birth prevalence for total and total severe microcephaly were 14.7 and 4.8 per 10,000 livebirths, respectively. For explained and unexplained cases, significantly elevated risks were noted for mothers who were older (35+), less educated (≤12 years), diabetic (pre-pregnancy or gestational), or had a preterm delivery. Unlike explained cases, however, mothers who were non-White or smoked had an increased risk for unexplained microcephaly. Furthermore, young maternal age (<20), multiparity, and higher BMI reduced the risk for unexplained microcephaly. For severe unexplained cases, the risk profile was similar to that for all unexplained cases—with the exception of null associations noted for diabetes and birth year. Conclusions: We found that risk patterns for microcephaly varied across case groupings. Risk factors included maternal race/ethnicity, age, and smoking during pregnancy. Among severe unexplained cases, notable positive associations were seen among mothers who were non-Hispanic Black or less educated, while inverse associations were noted for obesity.
KW - Texas Birth Defects Registry
KW - ZIKV
KW - Zika virus
KW - congenital microcephaly
KW - head circumference
KW - occipitofrontal circumference
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U2 - 10.1002/bdr2.1164
DO - 10.1002/bdr2.1164
M3 - Article
C2 - 29171191
AN - SCOPUS:85034962490
SN - 2472-1727
VL - 110
SP - 395
EP - 405
JO - Birth Defects Research
JF - Birth Defects Research
IS - 5
ER -