{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:41:56Z","timestamp":1787319716280,"version":"build-2736575974"},"reference-count":50,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Promotion Administration, Ministry of Health and Welfare, Taiwan","award":["E1041010-105, E1041010-105-1, E1041010-105-2"],"award-info":[{"award-number":["E1041010-105, E1041010-105-1, E1041010-105-2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In recent years, newborns born to immigrant mothers have accounted for about 10% of the total births in Taiwan. However, little is known about whether there are differences between newborns of immigrant and native-born mothers regarding the prevalence and the possible causes of birth defects. By combining four nationwide databases and assessing all newborns between 2005 and 2014 in Taiwan as research subjects, this study determined the prevalence of birth defects stratified into nine categories (neuronal, facial, cleft, circulatory, respiratory, digestive, urogenital, musculoskeletal and chromosomal abnormalities) in the newborns of immigrant mothers and native-born mothers. We found that the prevalence of any birth defects in newborns of immigrant mothers (ranging from 0.98 to 1.24%) was lower than that of native-born mothers (2.86%). Skeletomuscular system defects are the most common among newborns of women from the main immigrant countries (0.24\u20130.42%), while circulatory system defects were the most common among newborns of Taiwanese women (0.92%). The risks of all defects remained lower for newborns of immigrant mothers (AORs ranged from 0.37 to 0.47) after controlling for possible confounding variables. The higher rates of birth defects among newborns of native-born mothers may be attributed to an older maternal age at childbirth and a higher prevalence of diabetes than that of immigrant mothers. The findings from this study imply that the prevalence of birth defects between newborns of immigrant and native-born mothers is not similar, as evidenced by a decade of population-based data.<\/jats:p>","DOI":"10.3390\/ijerph182312530","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T04:48:37Z","timestamp":1638247717000},"page":"12530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Comparative Prevalence of Birth Defects between Newborns of Immigrant and Native-Born Mothers in Taiwan: Ten Years of Population-Based Data"],"prefix":"10.3390","volume":"18","author":[{"given":"Yu-Jung","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeng-Yuan","family":"Chiou","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Chung Shan Medical University, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0794-9388","authenticated-orcid":false,"given":"Jing-Yang","family":"Huang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pen-Hua","family":"Su","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Yuh","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Division of Neonatology, Changhua Christian Children\u2019s Hospital, Changhua 50050, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9565-0799","authenticated-orcid":false,"given":"Hao-Jan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/00006254-200107000-00005","article-title":"Survival and reproduction among males with birth defects and risk of recurrence in their children","volume":"56","author":"Lie","year":"2001","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1080\/15513815.2017.1303859","article-title":"Lethal congenital malformations in fetuses\u2014Antenatal ultrasound or perinatal autopsy","volume":"36","author":"Grover","year":"2017","journal-title":"Fetal Pediatr. Pathol."},{"key":"ref_3","unstructured":"World Health Organization (2015). Congenital Anomalies, WHO. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/congenital-anomalies."},{"key":"ref_4","unstructured":"(2021, January 21). Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), Available online: https:\/\/dep.mohw.gov.tw\/dos\/np-1776-113.html."},{"key":"ref_5","unstructured":"(2021, May 15). Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), Available online: https:\/\/www.hpa.gov.tw\/Pages\/Detail.aspx?nodeid=649&pid=13646."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s12311-008-0083-3","article-title":"Cerebellar disorders in childhood: Cognitive problems","volume":"7","author":"Steinlin","year":"2008","journal-title":"Cerebellum"},{"key":"ref_7","first-page":"311","article-title":"Effects of cleft lip and palate on childrens psychological health: A systematic review","volume":"13","author":"Alhubaishi","year":"2018","journal-title":"J. Taibah Univ. Medical Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/17405620344000004","article-title":"Chronic illness and aggressive behaviour: A population-based study of 4-year-olds","volume":"1","author":"Borge","year":"2004","journal-title":"Eur. J. Dev. Psychol."},{"key":"ref_9","unstructured":"(2021, January 21). Department of Household Registration, Ministry of the Interior, R.O.C., Available online: https:\/\/www.ris.gov.tw\/app\/portal\/346."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.2105\/AJPH.2014.302098","article-title":"The association between race\/ethnicity and major birth defects in the United States, 1999\u20132007","volume":"104","author":"Canfield","year":"2014","journal-title":"Am. J. Public Health."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Hsia, H. (2010). The subjectivation of marriage migrants in Taiwan: The insider\u2019s perspectives. Learning from the Ground Up, Palgrave Macmillan.","DOI":"10.1057\/9780230112650_7"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1177\/1363461514532306","article-title":"Culture, parenting, and child behavioral problems: A comparative study of cross-cultural immigrant families and native-born families in Taiwan","volume":"51","author":"Yang","year":"2014","journal-title":"Transcult. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Chen, J., Huang, X., Wang, B., Zhang, Y., Rongkavilit, C., Zeng, D., Jiang, Y., Wei, B., Sanjay, C., and McGrath, E. (2018). Epidemiology of birth defects based on surveillance data from 2011\u20132015 in Guangxi, China: Comparison across five major ethnic groups. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5947-y"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/j.1525-1497.2006.0512.x","article-title":"Race, ethnicity, culture, and disparities in health care","volume":"21","author":"Egede","year":"2006","journal-title":"J. Gen. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Schumann, B., Lundevaller, E.H., and Karlsson, L. (2019). Weather extremes and perinatal mortality\u2014Seasonal and ethnic differences in northern Sweden, 1800\u20131895. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223538"},{"key":"ref_16","first-page":"238","article-title":"Birth defects among immigrants: Impact of exposure to a new environment, a 20 year population-based study","volume":"12","author":"Agha","year":"2020","journal-title":"J. Public Health Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/j.1365-3016.2005.00632.x","article-title":"Ethnic differences in congenital malformations in the Netherlands: Analyses of a 5-year birth cohort","volume":"19","author":"Anthony","year":"2005","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s10903-016-0513-0","article-title":"Is there a healthy immigrant effect among women through transnational marriage? Results from immigrant women from Southeast Asian countries in Taiwan","volume":"20","author":"Huang","year":"2018","journal-title":"J. Immigr. Minor. Health."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1002\/ajmg.a.30618","article-title":"Prevalence of nonsyndromic oral clefts in Texas: 1995\u20131999","volume":"134A","author":"Hashmi","year":"2005","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1002\/bdra.20270","article-title":"Maternal birthplace and major congenital malformations among New York Hispanics","volume":"76","author":"Zhu","year":"2006","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_21","first-page":"83","article-title":"Comparisons of fertility rate and birth quality between native and foreign-born women in Taiwan","volume":"24","author":"Yang","year":"2001","journal-title":"J. Soc. Sci. Phil."},{"key":"ref_22","unstructured":"(2021, January 21). European Surveillance of Congenital Anomalies (EUROCAT): Prevalence Tables 2008\u20132012. Available online: http:\/\/www.eurocat-network.eu\/accessprevalencedata\/prevalencetables."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bellizzi, S., Ali, M.M., Abalos, E., Betran, A.P., Kapila, J., Pileggi-Castro, C., Vogel, J.P., and Merialdi, M. (2016). Are hypertensive disorders in pregnancy associated with congenital malformations in offspring? Evidence from the WHO Multicountry cross sectional survey on maternal and newborn health. BMC Pregnancy Childbirth, 16.","DOI":"10.1186\/s12884-016-0987-8"},{"key":"ref_24","first-page":"27","article-title":"Environmental factors influencing the risk of autism","volume":"22","author":"Karimi","year":"2017","journal-title":"J. Res. Med. Sci. Off. J. Isfahan Univ Med. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1002\/bdr2.1606","article-title":"Genome-wide association studies of structural birth defects: A review and commentary","volume":"111","author":"Lupo","year":"2019","journal-title":"Birth Defects Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1002\/bdr2.1880","article-title":"Gene\u2013environment interactions between air pollution and biotransformation enzymes and risk of birth defects","volume":"113","author":"Padula","year":"2021","journal-title":"Birth Defects Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11027","DOI":"10.1038\/s41598-021-90387-0","article-title":"Congenital anomalies among newborn babies in Felege-Hiwot Comprehensive specialized referral hospital, Bahir Dar, Ethiopia","volume":"11","author":"Mekonnen","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.envpol.2017.11.023","article-title":"Does maternal environmental tobacco smoke interact with social-demographics and environmental factors on congenital heart defects?","volume":"234","author":"Liu","year":"2018","journal-title":"Environ. Pollut."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"887e","DOI":"10.1097\/PRS.0000000000002656","article-title":"Barriers to reconstructive surgery in low-and middle-income countries: A cross-sectional study of 453 cleft lip and cleft palate patients in Vietnam","volume":"138","author":"Yao","year":"2016","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"59","DOI":"10.12688\/f1000research.50738.2","article-title":"Risk factors for major external structural birth defects among children in Kiambu County, Kenya: A case-control study","volume":"10","author":"Agot","year":"2021","journal-title":"F1000Research"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13690-020-00443-w","article-title":"Major birth defects in the Brazilian side of the triple border: A population-based cross-sectional study","volume":"78","author":"Souza","year":"2020","journal-title":"Arch. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13052-019-0635-9","article-title":"Prevalence, types, and malformations in congenital anomalies of the kidney and urinary tract in newborns: A retrospective hospital-based study","volume":"45","author":"Li","year":"2019","journal-title":"Ital. J. Pediatr."},{"key":"ref_33","unstructured":"(2021, January 21). Health Promotion Administration, Ministry of Health and Welfare, R.O.C (Taiwan), Available online: https:\/\/www.hpa.gov.tw\/Pages\/Detail.aspx?nodeid=4141&pid=12969."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jfma.2019.08.006","article-title":"Birth defects in Taiwan: A 10-year nationwide population-based, cohort study","volume":"119","author":"Chen","year":"2020","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e95085","DOI":"10.1172\/jci.insight.95085","article-title":"Epigenetic mechanisms underlying maternal diabetes-associated risk of congenital heart disease","volume":"2","author":"Basu","year":"2017","journal-title":"JCI Insight"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1161\/CIRCULATIONAHA.115.017465","article-title":"Prepregnancy diabetes and offspring risk of congenital heart disease: A nationwide cohort study","volume":"133","author":"Diaz","year":"2016","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/s41581-020-0278-5","article-title":"Genetics of diabetes mellitus and diabetes complications","volume":"16","author":"Cole","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"107811","DOI":"10.1016\/j.diabres.2019.107811","article-title":"Effects of pre-gestational diabetes mellitus and gestational diabetes mellitus on macrosomia and birth defects in upstate New York","volume":"155","author":"Yang","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/bdr2.1157","article-title":"Birth defect survival for Hispanic subgroups","volume":"110","author":"Lopez","year":"2018","journal-title":"Birth Defects Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1111\/jdi.13595","article-title":"Increasing trend in the prevalence of gestational diabetes mellitus in Taiwan","volume":"12","author":"Su","year":"2021","journal-title":"J. Diabetes Investig."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2659","DOI":"10.1097\/MD.0000000000002659","article-title":"Incidence and risks of congenital anomalies of kidney and urinary tract in newborns: A population-based case-control study in Taiwan","volume":"95","author":"Tain","year":"2016","journal-title":"Medicine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s10995-016-2209-4","article-title":"Pre-pregnancy obesity as a modifier of gestational diabetes and birth defects associations: A systematic review","volume":"21","author":"Parnell","year":"2017","journal-title":"Matern Child Health J."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Miao, Q., Dunn, S., Wen, S.W., Lougheed, J., Reszel, J., Venegas, C.L., and Walker, M. (2021). Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease. BMC Pregnancy Childbirth, 21.","DOI":"10.1186\/s12884-020-03512-8"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jpeds.2009.11.062","article-title":"Prevalence of congenital heart disease at live birth in Taiwan","volume":"156","author":"Wu","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_45","unstructured":"(2021, January 21). Department of Household Registration, Ministry of the Interior, R.O.C., (In Chinese)."},{"key":"ref_46","unstructured":"Kim, Y.Y. (2021, January 21). Cross-Cultural Adaptation. Oxford Research Encyclopedia of Communication. Available online: https:\/\/oxfordre.com\/communication\/view\/10.1093\/acrefore\/9780190228613.001.0001\/acrefore-9780190228613-e-21."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1093\/aje\/142.Supplement_9.S30","article-title":"Effect of United States Residence on Birth Outcomes among Mexican Immigrants: An Exploratory Study","volume":"142","author":"Guendelman","year":"1995","journal-title":"Am. J. Epidemiol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lien, M.H., Huang, S.S., and Yang, H.J. (2021). A pathway to negative acculturation: Marital maladjustment mediates the relationship between the length of residency and depressive symptoms in immigrant women in Taiwan. BMC Women\u2019s Health, 21.","DOI":"10.1186\/s12905-021-01334-0"},{"key":"ref_49","first-page":"413","article-title":"Age and gender variations in healthy immigrant effect: A population study of immigrant well-being in Canada","volume":"19","author":"Kwak","year":"2018","journal-title":"J. Int. Migr. Integr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/j.1471-0528.2010.02523.x","article-title":"Immigrants\u2019 duration of residence and adverse birth outcomes: A population-based study","volume":"117","author":"Urquia","year":"2010","journal-title":"BJOG Int. J. Obstet. Gynaecol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:36:57Z","timestamp":1760168217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,28]]},"references-count":50,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182312530"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182312530","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,28]]}}}