Socioeconomic inequalities in risk of congenital anomaly

• Published in: Archives of disease in childhood 2000-05, Vol.82 (5), p.349-352
• Main Authors: Vrijheid, M, Dolk, H, Stone, D, Abramsky, L, Alberman, E, Scott, J E S
• Format: Article
• Language: English
• Subjects: Anatomy; Attrition (Research Studies); Biological and medical sciences; British Isles; Case-Control Studies; Chromosome Aberrations - epidemiology; Chromosome Aberrations - etiology; Chromosome Disorders; Community Child Health, Public Health, and Epidemiology; Congenital Abnormalities - epidemiology; Congenital Abnormalities - etiology; congenital anomaly; Congenital defects; Congenital Impairments; deprivation; Digestive system; Down Syndrome; Down Syndrome - epidemiology; Down Syndrome - etiology; Hazardous Materials; Hazardous Waste - adverse effects; Hazardous wastes; Health risk assessment; Households; Humans; inequalities; Infant, Newborn; Landfills; Malformations of the nervous system; Maternal Age; Medical sciences; Metabolic disorders; Needs Assessment; Neurology; Odds Ratio; Pregnancy; Registries; Risk Factors; Risk reduction; Social Class; Socioeconomic factors; Socioeconomic Status; Socioeconomics; Statistical Significance; Studies; United Kingdom - epidemiology; Waste disposal sites; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.82.5.349

AIMS To investigate socioeconomic inequalities in the risk of congenital anomalies, focusing on risk of specific anomaly subgroups. METHODS A total of 858 cases of congenital anomaly and 1764 non-malformed control births were collected between 1986 and 1993 from four UK congenital malformation registers, for the purposes of a European multicentre case control study on congenital anomaly risk near hazardous waste landfill sites. As a measure of socioeconomic status, cases and controls were given a value for the area level Carstairs deprivation index, by linking the postcode of residence at birth to census enumeration districts (areas of approximately 150 households). RESULTS Risk of non-chromosomal anomalies increased with increasing socioeconomic deprivation. The risk in the most deprived quintile of the deprivation index was 40% higher than in the most affluent quintile. Some malformation subgroups also showed increasing risk with increasing deprivation: all cardiac defects, malformations of the cardiac septa, malformations of the digestive system, and multiple malformations. No evidence for socioeconomic variation was found for other non-chromosomal malformation groups, including neural tube defects and oral clefts. A decreasing risk with increasing deprivation found for all chromosomal malformations and Down's syndrome in unadjusted analyses, occurred mainly as a result of differences in the maternal age distribution between social classes. CONCLUSION Our data, although based on limited numbers of cases and geographical coverage, suggest that more deprived populations have a higher risk of congenital anomalies of non-chromosomal origin and some specific anomalies. Larger studies are needed to confirm these findings and to explore their aetiological implications.