Presentation at ICBD 2020

Abstract Global, Regional, and National Levels and Trends in Congenital Birth Defects, 1990-2019

Lauren B Wilner, Nick J Kassebaum

Introduction and objectives: The Global Burden of Diseases, Injuries and Risks (GBD) 2017 study is a comprehensive effort to evaluate comparative health loss that quantifies mortality and morbidity from congenital birth defects globally for ages 0-69 years, by country, age, sex, and year.

Methods: Cause-of-death ensemble modeling (CODEm) tested all covariate combinations to maximize out-of-sample predictive validity of cause fraction and rate models informed by vital registration, surveillance, verbal autopsy, and CHAMPS/MITS data, all of which was corrected for completeness and misclassification. Nonfatal disease burden was modeled in DisMod-MR 2.1, a Bayesian meta-regression tool, for 29 different defect-specific models informed by registry data, ICD-coded administrative data, and published studies that were extracted and standardized to the reference case definition, including correction for compositional bias in some sources that only report a subset of defects.

Results: There were 5.296 million (95% CI: 4.953 – 5.703 million) babies born with congenital birth defects in 1990, and that was similar in 2017 with 5.445 million (95% CI: 5.088 – 5.844 million) babies born with congenital birth defects. This translates to a rate of approximately 3,866 per 100,000 live births (95% CI: 3,615 – 4,163 per 100,000) in 2017 and 3,922 per 100,000 live births (95% CI:3,615 – 4,163 per 100,000) in 2019. However, deaths due to congenital birth defects across all ages significantly decreased from 826,877 (95% CI: 743,550 – 996,616) in 1990 to 584,861 (95% CI: 556,252 – 618,250) in 2017. Accordingly, prevalence of congenital birth defects for all ages has increased from 74.80 million people (95% CI: 70.99 – 79.12 million) in 1990 to 100.4 million people (95% CI: 95.15 – 106.5 million) in 2017. Among the sub-causes of congenital birth defects, congenital musculoskeletal defects have been the most prevalent, and congenital heart defects have been responsible for the most deaths.

Conclusions: While incidence of congenital birth defects has remained relatively constant, there has been a dramatic increase in the number of people living with congenital birth defects. This necessitates increased support services for these individual living with birth defects around the world.