{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:17:12Z","timestamp":1791433032269,"version":"4.3.3"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital malformations remain a major cause of under-five mortality in the United States, yet contemporary long-term trends and demographic disparities have not been comprehensively evaluated. This study examined national patterns in congenital malformation-related mortality among U.S. children under 5 years from 1999 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mortality data were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) Database, focusing on congenital malformations-related deaths among children aged under 5 years between 1999 and 2023 in the U.S. Cases were identified using ICD-10 codes from Q00 to Q89.9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This comprehensive analysis included a total of 143,931 deaths, demonstrating significant trends and disparities. The overall age-adjusted mortality rate (AAMR) declined from 34.70 (95% CI: 33.86\u201335.54) in 1999 to 25.95 (95% CI: 25.21\u201326.68) in 2023, showing an average annual percentage change (AAPC) of \u22121.21 (95% CI: \u22121.50 to \u22121.02). Mortality was higher in males than in females. Across all races, the least decline was noted among NH American Indian or Alaska Natives. Non-metropolitan areas exhibited higher overall AAMR (34.80 [95% CI: 34.33\u201335.27]) compared to metropolitan areas (29.02 [95% CI: 28.85\u201329.19]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The overall AAMR decreased from 1999 to 2023, with significantly higher deaths among males, rural regions and Alaskan Natives. These findings demonstrate an overall decline in mortality but persistent demographic and geographic inequities, highlighting the need for targeted public health and policy interventions to improve outcomes for vulnerable pediatric populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798261424787","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T10:37:13Z","timestamp":1770460633000},"page":"484-494","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Congenital malformations-related mortality trends in under-five U.S. children: A 24-year analysis from CDC-WONDER database (1999\u20132023)"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4273-0827","authenticated-orcid":false,"given":"Shree","family":"Rath","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences Bhubaneswar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8425-6395","authenticated-orcid":false,"given":"Ahmed","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", Jinnah Sindh Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5251-9363","authenticated-orcid":false,"given":"Muhammad","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", Dow International Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha","family":"Waseem","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", Fakeeh University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6896-2052","authenticated-orcid":false,"given":"Kumail Mustafa","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", Jinnah Sindh Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5472-2550","authenticated-orcid":false,"given":"Arham Khalid","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", King Edward Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umama","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":", Khyber Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Lal","sequence":"additional","affiliation":[{"name":"Pennsylvania State University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.54.9.660"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20218"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.16965\/ijar.2017.393"},{"key":"e_1_3_7_5_2","volume-title":"Global report on birth defects","author":"Christianson A","year":"2006","unstructured":"Christianson A, Howson CP, Modell B. 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