{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:58:24Z","timestamp":1782950304930,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Information on prevalence, predictors, and causes of mortality is sparse among persons born with spina bifida (SB), especially adults over age 25\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals with SB born in 1981\u20132018 were identified in surveillance data from the Metropolitan Atlanta Congenital Defects Program, an active population\u2010based birth defects surveillance system, and linked with Georgia death certificates (1981\u20132021). Survival probability was assessed using Kaplan\u2013Meier curves. Selected factors were examined using Cox proportional hazards regression, estimating crude (cHR) and adjusted hazards ratios (aHR) and 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 458 infants born with SB, 341 met eligibility criteria; 18% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961) died. The overall 25\u2010year and 35\u2010year survival probabilities were 82% and 75%, respectively. Survival improved between 1981\u20131999 and 2000\u20132018 for individuals with isolated SB (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), but not for those with multiple defects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41). Preterm birth (aHR\u2009=\u20092.28; 95% CI\u2009=\u20091.32, 3.95), having multiple major birth defects (aHR\u2009=\u20092.07; 95% CI\u2009=\u20091.04, 4.13), or upper\u2010level spinal lesion (aHR\u2009=\u20093.86; 95% CI\u2009=\u20092.23, 6.69) was associated with increased mortality risk. SB was often listed as the cause of death, even among adults; respiratory and cardiovascular conditions and infections were other commonly listed causes for mortality after infancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Survival for individuals with isolated SB improved over time; further improvements might be achieved by targeting age\u2010specific risk factors in clinical and public health settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70028","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T04:26:47Z","timestamp":1770870407000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality Through 2021 Among Persons Born With Spina Bifida in Metropolitan Atlanta, 1981\u20132018"],"prefix":"10.1002","volume":"118","author":[{"given":"Vijaya","family":"Kancherla","sequence":"first","affiliation":[{"name":"Department of Epidemiology Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-7601","authenticated-orcid":false,"given":"Victoria Konrad","family":"Markwalter","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Cragan","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth B.","family":"Gray","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharine","family":"Riley","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennita","family":"Reefhuis","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017\u20103730"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.17275"},{"issue":"12","key":"e_1_2_11_4_1","first-page":"1","article-title":"United States Life Tables, 2021","volume":"72","author":"Arias E.","year":"2023","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12589"},{"issue":"2","key":"e_1_2_11_6_1","first-page":"225","article-title":"Spina Bifida and Hydrocephalus: A Population Study Over a 35\u2010Year Period","volume":"44","author":"Bamforth S. 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