Agregados geográficos, condición socioeconómica y prevalencia de anomalías congénitas en Argentina

the objetive was the analysis of the prevalence of ten congenital defects in geographic clusters (gc) in argentina. a sample of 16,606 newborn with congenital anomalies and their control pairs was selected out of 39 maternities belonging to the eclamc network, ascertained from 577.844 births in 25 argentine counties between 1991 and 2001. in order to identify the gc, the nbi -unsatisfi ed basic needs- level (2001 census) was used as a socioeconomic indicator for each county to which the hospital belongs. ten congenital defects were chosen due to their clinical and biological importance. in order to estimate the prevalence rate ratio for each gc in relation to the frequency of the anomaly observed for gc rest, a poisson regression analysis was used, adjusted by different hospitals from the same cluster. four gc were identifi ed: three unfavourable regions with high nbi level (bariloche, futaleufú: 20,6%, gran buenos aires: 18,6% and noroeste: 18,4%), and a favourable region with low nbi level (ciudad autónoma de buenos aires, 7,8% ). the fi fth gc corresponded to hospitals not included in the gc defi ned by the program. the fi ve gc were grouped into three: high nbi percentage (gc1, unfavourable cluster), low nbi (gc2, favourable cluster) and all the rest (gc3). a high frequency of cleft lip with cleft palate was observed for gc1, while esophageal atresia and hydronephrosis frequencies were low. spina bifi da and congenital heart defect showed higher frequencies for gc2.