Infant mortality and congenital anomalies from 1950 to 1994: an international perspective

Study objective-To provide an international perspective on the impact of co ngenital anomalies on infant mortality from 1950 to 1994. Design-Population-based study based on data obtained from vital statistics reported to the World Health Organisation. Settings-36 countries from Europ e, the Middle East, the Americas, Asia, and the South Pacific. Results-On average, infant mortality declined 68.8 per cent from 1950 to 19 94. In the countries studied, infant mortality attributable to congenital a nomalies decreased by 33.4 per cent, although it recently increased in some countries in Central and Latin America and in Eastern Europe. Anomalies of the heart and of the central nervous system accounted for 48.9 per cent of infant deaths attributable to congenital anomalies. During 1990-1994, infa nt mortality attributable to congenital anomalies was inversely correlated to the per capita gross domestic product in the countries studied. At the s ame time, the proportion of infant deaths attributable to congenital malfor mations was directly correlated with the per capita gross domestic product. Conclusions-Congenital malformations account for an increasing proportion o f infant deaths in both developed and developing countries. Infant mortalit y attributable to congenital anomalies is higher in poorer countries althou gh as a proportion of infant deaths it is greater in wealthier countries. C onditions such as spina bifida, whose occurrence can be reduced through pre ventive strategies, still cause many infant deaths. The apparent increase o f infant mortality because of congenital anomalies in some countries should be investigated to confirm the finding, find the causes, and provide preve ntion opportunities.