Congenital infections cause significant morbidity globally. In the United States, population studies have indicated that congenital infections disproportionately affect minorities and the economically disadvantaged. Through their chronic and disabling effects these infections perpetuate generational poverty among these groups. The objectives of this study were to 1) provide a national prevalence estimate of congenital infections in children 0 – 2 years using discharge diagnosis codes; 2) compare risk of congenital infection between white and non-white children; and 3) investigate the relationship between socioeconomic status and risk of congenital infection in the US.
The 2012 HCUP Kids’ Inpatient Database was used to identify discharges of children 0 – 2 years with an ICD-9 diagnosis code for congenital CMV (771.1), congenital syphilis (090.0-9), or congenital infection other (771.2). Univariate and multivariate logistic regression was used to estimate prevalence rates and potential risk factors for these infections.
Prevalence of any congenital infection in children ages 0 – 2 years is .048%. Risk factor analyses found that African-American children are 1.85 times more likely to have any congenital infection compared to Caucasians (95% CI: 1.56 – 2.20), 1.49 times more likely to have congenital CMV (95% CI: 1.10 – 2.02), and 5.97 times more likely to have congenital syphilis (95% CI: 4.36 – 8.17). Children with private insurance are less likely than those with Medicaid to have any congenital infection (RR = 0.54, 95% CI: 0.43 – 0.66), congenital CMV (RR = 0.49, 95% CI: 0.37 – 0.65), or congenital syphilis (RR = 0.29, 95% CI: 0.19 – 0.43). Lastly, children from higher income households are less likely than those of lower income to have any congenital infection (RR = 0.87, 95% CI: 0.80 – 0.94).
Risk for congenital infections in children 0 – 2 years in the United States is substantially higher for non-whites, those with Medicaid insurance, and those in lower income households supporting previous literature suggesting that these infections disproportionately affect socially and economically disadvantaged groups. Further research is needed to define optimal cost-effective screening and prevention strategies.
A. F. Veesenmeyer,