ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1485176
Association of birth defects during the perinatal period with child mortality under 5 years
Provisionally accepted
- 1Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
- 2School of Public Health, Central South University, Changsha, Hunan Province, China
- 3School of Public Health, University of South China, Hengyang, Hunan Province, China
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Objective: To calculate the impact of birth defects (BDs) diagnosed during the perinatal period on the mortality of children under 5 years of age.This was a retrospective cohort analysis. From the monitoring system, we collected all hospital delivery, BD monitoring, and death information for children under 5 years in Hunan Province from 2017 to 2022. These data were linked by ID number. Mortality rates and Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the impact of BDs on mortality in children under 5 years of age.Results: Among 3,807,340 live-born children, 29,879 (0.8%) had at least one type of BDs during the perinatal period, with a total of 12,215,033 person-years of follow-up. The mortality rate of the BDs group was 14.5% (95% CI: 13.7-15.3) per 1000 person-years, which was 11.6 times (HR=11.6, 95% CI: 10.5-12.8) greater than that of the nondefect group. The mortality rate per 1000 person-years of girls with BDs was higher than that of boys (15.4% vs. 13.5%). For the BDs group, congenital anomalies (CAs) were the most common cause of death (57.2%). Compared with children without BDs, those with BDs had elevated mortality risks for CAs (HR, 58.1; 95% CI, 42.7-79.0), digestive (HR=16.5, 95% CI: 6.1-45.0) and respiratory system malformations (HR, 11.9; 95% CI, 7.9-17.8), and cancer (HR=11.1 95% CI: 4.7-26.2).This study revealed that BDs were strongly associated with mortality under 5 years of age, especially in the first 28 days, for muscular, chromosomal, genetic, and nervous system abnormalities.
Keywords: Birth defects, mortality rate under 5 years, Cause of Death, hazard ratio, confidence intervals, Person-years
Received: 01 Sep 2024; Accepted: 16 Jul 2025.
Copyright: © 2025 Xie, Wei, Xiong, Zhu, Peng, Zou and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bo Li, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
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