[Infant mortality from congenital malformations in Chile: temporal and spatial analysis, 1997-2011]. / Mortalidad infantil por malformaciones congénitas en Chile: análisis temporal y espacial, 1997-2011.

ABSTRACT

OBJECTIVE: To analyze the spatial and temporal distribution (1997-2011) of infant mortality resulting from congenital malformations (CM) in Chile. METHODS: Data on births and deaths among infants aged less than one year using ICD-10 coding were obtained from the National Statistics Institute. The percentage of deaths from CM (PD-CM) and the infant mortality rate from CM (IMR-CM) during three different periods (1997-2001, 2002-2009, 2007-2011) were estimated for Chile's administrative and natural regions (Norte Grande, Norte Chico, Central, Austral, and Sur), broken down by systems (nervous, cardiovascular, digestive, genitourinary, musculoskeletal, and chromosomal abnormalities) and by 28 specific malformations. The secular trend and the variation in the risk of death were estimated using a Poisson regression model. RESULTS: For the whole of Chile, the secular trend for the IMR-CM was negative, and the secular trend for the PD-CM was positive (P < 0,01). The IMR-CM and the PD-CM both showed mild spatial heterogeneity in all administrative and natural regions. The Central region was the natural region that came closest to showing the pattern observed nationwide. The IMR-CM involving the nervous and cardiovascular systems and specific types of CM (anencephaly, spina bifida, and atrial and ventricular septal defects) showed a negative secular trend. For Chile as a whole, the pattern of infant mortality from CM is marked by a drop in the IMR-CM and by an increase in the PD-CM over the period from 1997 to 2011. CONCLUSION: The findings suggest that Chile is in the latter stages of the epidemiological transition with respect to the causes of infant mortality. However, these indicators show disparities between regions, more pronounced in the south of the country.