Congenital malformations in offspring of Hispanic and African‐American women in California, 1989–1997

Abstract
BACKGROUND Little is known about risks of most specific birth defects among infants born to U.S.-born and foreign-born Hispanic or African-American women. METHODS Using data from a large population-based registry, we explored risks of selected congenital malformation phenotypes in offspring of U.S.-born and foreign-born Hispanic and African-American women, relative to non-Hispanic white women, in California. Approximately 2.2 million live births and stillbirths occurred during the ascertainment period, 1989–1997. Information on maternal racial-ethnic background and other covariates was obtained from birth certificate and fetal death files. RESULTS Adjusted relative risks (ARRs) for the 20 groupings of malformations designated by three-digit British Pediatric Association (BPA) codes ranged from 0.6 (genital organ malformations, among infants born to foreign-born Hispanics) to 1.7 (anencephaly, also among infants born to foreign-born Hispanics). Grouping by four-digit BPA codes revealed that among infants born to U.S.-born Hispanics, 46 of the ARRs were ≤0.8 and 12 were ≥1.3; among infants born to foreign-born Hispanics, 75 of the ARRs were ≤0.8 and 15 were ≥1.3; and among infants born to African-American women, 45 ARRs were ≤0.8 and 25 were ≥1.3. For each racial-ethnic group of women, the observed variability in risks covered most organ systems. CONCLUSIONS Although the results suggested that (in comparison with non-Hispanic whites) each racial-ethnic group was more likely to have reduced risk for specific defects (rather than elevated risk), in general, the range of the relative risks was comparatively narrow. Birth Defects Research (Part A), 2004.