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An Assessment of Risk Factors

Karen M. Kaplan, MD; Stephen L. Cochi, MD; Larry D. Edmonds, MSPH; Elizabeth R. Zell, MS; Stephen R. Preblud, MD

Am J Dis Child. 1990;144(1):118-123.

Abstract
• To formulate strategies for elimination of congenital rubella syndrome, it is important to identify risk factors for delivering an infant affected by it. We analyzed cases of congenital rubella syndrome in infants born from 1970 to 1985 and reported to either one of two independent Centers for Disease Control surveillance systems. Mothers of infants with congenital rubella syndrome identified in both surveillance systems were disproportionately younger than mothers giving birth in the United States. The risk for delivering an infant with congenital rubella syndrome was approximately 2.5 times higher for blacks compared with whites for both reporting systems. A total of 18% of infants with congenital rubella syndrome born since 1979 were Hispanic (national population average, 7%). Both surveillance systems showed that, although primiparous mothers were at highest risk, 39% of women delivering infants affected by congenital rubella syndrome had had at least one previous live birth, suggesting that postpartum immunization could have prevented these congenital rubella syndrome cases. Young, black, and Hispanic primiparous women represent populations at elevated risk for delivering a congenital rubella syndrome-affected infant and should be specifically targeted for immunization.

(AJDC. 1990;144:118-123)

Author Affiliations
From the Division of Immunization, Center for Prevention Services (Drs Kaplan, Cochi, and Preblud, and Ms Rovira), and the Division of Birth Defects and Developmental Disabilities, Center for Environmental Health and Injury Control (Mr Edmonds), Centers for Disease Control, Atlanta, Ga.

Footnotes
Accepted for publication September 5, 1989.

Deceased.

Presented in part at the 28th Interscience Conference on Antimicrobial Agents and Chemotherapy, Los Angeles, Calif, October 24, 1988.

Reprint requests to Technical Information Services, Center for Prevention Services, Centers for Disease Control, Atlanta, GA 30333.

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