Patterns of infant mortality caused by major congenital anomalies

Background: We assessed the impact of recent advances in perinatal care on infant mortality due to congenital anomaly. Methods: Analysis of trends in congenital anomaly-attributed infant mortali ty, using the 1981-1995 Statistics Canada's birth and death records, with a total of 2,878,826 live births, 21,883 infant deaths, and 6,908 infant dea ths due to congenital anomalies. Results: infant mortality due to major congenital anomaly decreased from 3. 11 per 1,000 live births in 1981 to 1.89 per 1,000 live births in 1995. Cau se-specific infant mortality rates for anencephaly, spina bifida, other cen tral nervous system anomalies, car diovascular system anomalies, respirator y system anomalies, digestive system anomalies, certain musculo-skeleton an omalies, urinary system anomalies, chromosomal anomalies, and multiple cong enital anomalies were 0.20, 0.23, 0.27, 1.04, 0.24, 0.08, 0.22, 0.16, 0.22, and 0.13 per 1,000 live births, respectively, in 1981-1983, whereas corres ponding rates were 0.07, 0.07, 0.18, 0.73, 0.25, 0.03, 0.12, 0.12, 0.26, an d 0.06 per 1,000 live births, respectively, in 1993-1995. Conclusions: Recent Canadian data show that infant deaths caused by major c ongenital anomalies have decreased significantly, but reductions varied sub stantially according to specific forms of anomalies. (C) 2000 Wiley-Liss, I nc.