Infant mortality due to congenital defects in Costa Rica: 2010-2018 update.

Aim. This study aims to identify the trend of the different types of congenital defects in the infant and neonatal mortality rate in Costa Rica during the period 2010-2018 and to compare it with the period 2000-2009. Methods. A vital statistics analysis was performed. The source of information was the Costa Rican National Institute of Statistics and Censuses, through its public domain system and online consultation, the base of deaths by cause and the base of births for the period 2000-2018 were consulted. The causes of death due to congenital defects were grouped by system, in addition, the defects with the highest mortality in the study period were selected for their specific analysis. To describe the behavior of infant mortality due to congenital defects in 2010-2018 concerning the previous decade, infant and neonatal mortality rates were calculated for the periods 2000-2009 and 2010-2018 with their respective confidence interval (95% CI). A linear Poisson Log regression model was constructed for each group of congenital defects and for the specific defects selected, taking the sub-periods compared as an adjustment factor. Prevalence ratios were estimated and compared using Wald’s chi-square based on the period 2000-2009. Results. In the last two decades, birth defects caused 29% to 38% of overall infant mortality. The infant mortality rate due to congenital defects from 2000 to 2009 was 3.19 (95% CI: 3.06-3.32) and presented a significant decrease to 2.97 (95% CI: 2.84-3.11) in the 2010-2018 period. This decrease was given at the expense of the impairment of the circulatory and digestive systems. When analyzing infant mortality due to specific congenital defects, a significant decrease was shown only in spina bifida and some cardiac defects: transposition of the great arteries, ventricular septal defect, aortic coarctation, and other unspecified cardiac anomalies. The neonatal mortality rate due to congenital defects did not vary significantly between the periods compared, in 2000-2009 it was 2.13 (95% CI: 2.03-2.24) and 2.17 (95% CI: 2.06-2, 29) in 2010-2018. The only group of congenital defects that presented a significant decrease in the neonatal mortality rate in the last decade was the circulatory system. Conclusions. In the last decade, there was a significant decrease in the infant mortality rate due to congenital defects. This decrease was mainly due to a significant decrease in infant and neonatal mortality rates from heart defects.

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