Survival of babies with birth defects depends on geographical location, shows study

on 21 July 2021

A study has found that the survival rate of babies born with birth defects depends on where in the world they were born.

The study, published in The Lancet and conducted in Australia and New Zealand, examined the risk of mortality for around 4,000 babies born with birth defects across 264 hospitals around the world in low, middle and high-income countries.

It was found that babies born with birth defects involving the intestinal tract had a two in five chance of dying if they were born in a low-income country, compared to one in 20 if they were born in a high-income country.

Gastroschisis, where a baby’s intestines protrude through a hole by the umbilicus, had the greatest difference in mortality rates with 90% of babies dying in low-income countries compared to 1% in high-income countries.

Dr Brendan Jones, a co-country lead for Australia and New Zealand for the research, said: “Associate Professor Sebastian King, Dr Damir Ljuhar and I coordinated the study in Australia and New Zealand and are saddened, but unfortunately not surprised, by the incredible disparities between high-income nations like Australia and New Zealand and low-income countries.

“In Australia and New Zealand, we routinely care for children with diseases like gastroschisis with full expectation that the baby will not only survive but go on to thrive and live a full life. Australia and New Zealand should be proud that we can offer this expectation to our children and their parents.

“Following our participation in this study, we encourage Australia and New Zealand to play a leading role in improving surgical care for children beyond our borders.”

The research highlights the need for more focus on improving surgical care for newborns in low- and middle-income countries globally.

Birth defects are now the fifth leading cause of death for children under the age of five years, with most deaths occurring in the newborn period.

Principal Investigator for the disparities in these outcomes, Naomi Wright, said: “Geography should not determine outcomes for babies who have correctible surgical conditions. The Sustainable Development Goal to end preventable deaths in newborns and children under five years old by 2030 is unachievable without urgent action to improve surgical care for babies in low- and middle-income countries.”

The research ‘Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income and high-income countries: a multicentre, international, prospective cohort study’ can be found here.