Epidemiology of Anencephalus and Spina Bifida

Godfrey P. Oakley Jr, MD
JAMA. 1980;244(24):2769. doi:10.1001/jama.1980.03310240061032.
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In Western societies, congenital malformations are the leading cause of infant mortality. In some countries, we are approaching the time when improvements in infant mortality can come only from improvement in mortality associated with malformations. The vast majority of epidemiologic studies of infant mortality have sought predictors by looking for associations between various factors and total infant mortality. Infant mortality is not, however, a single disease, but many diseases. There is little wonder that our approach so far has not been productive. What would we learn of the epidemiology of the infectious diseases if we always considered them to be a single entity? We must move from studies of all infant mortality to studies of specific causes. It is heartening that the Elwood brothers have produced such a splendid example of the kind of cause-specific infant mortality epidemiology that is so badly needed. I highly recommend this volume to those


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