Survival of infants with spina bifida--Atlanta, 1972-1979
M. M. Adams, F. Greenberg, M. J. Khoury, J. S. Marks and G. P. Oakley Jr
We studied the survival of a population-based cohort of 154 infants with
spina bifida who were born during the eight-year period from 1972 through
1979 to residents of Atlanta. Our objectives were to describe the cohort's
survival experience and to explore relationships between clinical
characteristics and survival. Overall, 57% of the cohort survived one year
or more. This figure is misleading, however, because it conceals important
differences in survival among subgroups of affected infants. From
univariate analyses, we observed significant differences in survival among
infants categorized by year of birth, birth weight, the open-closed status
of the defect, the highest level of the defect on the spine, the presence
of multiple major birth defects, and the presence of hydrocephalus at
birth. More infants born in the late 1970s survived their first year of
life than infants born in the early 1970s; infants with open defects had
lower survival than those with closed defects; and infants whose defects
were low on the spine had better survival than those whose defects were
higher. When comparing the survival experience of this cohort with that of
other groups from other areas or from more recent years, health workers
must consider referral biases and differences in the distribution of
clinical characteristics.
