The mortality burden associated with congenital defects (CD) is relevant globally and regionally. In 2016, the global prevalence of CD reached 82,890,000 cases. One out of five deaths within the first 28 days of life is due to CD. In addition to neonatal mortality due to CD, it contributes to fetal mortality.
One in three CD-related deaths in the region is due to congenital malformations of the heart, the leading cause of death in this group; this trend has been steady over time. These are followed in frequency by defects of the musculoskeletal system, digestive system, urogenital and neural tube.
The reduction of other preventable causes of death in the neonatal stage increases the share of CD-related neonatal deaths.
The trend and contribution of this group of causes varies from one country to another, based on the sensitivity of cause of death records, access to antenatal diagnostic techniques in each population, and the possibility of voluntary termination of pregnancy.
The percentage of CD-related deaths varies among countries according to their neonatal mortality rate (NMR):
- NMR under 6 deaths per 1,000 live births: CD deaths account for 15-40% of neonatal deaths.
- NMR greater than 12 per 1,000 live births: deaths due to congenital defects account for less than 15% of all deaths.
- NMR between 6 and 12 per 1,000 live births: behavior is variable, with neonatal mortality ranging from 10 to 30%.
The implementation of specific effective actions succeeded in eliminating certain causes, such as congenital rubella syndrome. In 2015, the epidemiological evidence presented by PAHO member countries showed that the Region of the Americas eliminated the endemic transmission of rubella and congenital rubella, the first Region in the world to eradicate them, along with smallpox and polio.
To maintain these conditions, PAHO and the International Committee of Experts for the Elimination of Measles and Rubella recommend that all countries of the Americas strengthen active surveillance and maintain high immunity in the population through vaccination.
