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. 2023 Jan 1;115(1):67-78.
doi: 10.1002/bdr2.2130. Epub 2022 Nov 17.

Factors associated with nonsyndromic anotia and microtia, Texas, 1999-2014

Jeremy M Schraw  1 , J P Woodhouse  1 , Renata H Benjamin  2 , Charles J Shumate  3 , Joanne Nguyen  3   4 , Mark A Canfield  3 , A J Agopian  2 , Philip J Lupo  1
Affiliations

Factors associated with nonsyndromic anotia and microtia, Texas, 1999-2014

Jeremy M Schraw et al. Birth Defects Res. .

Abstract

Background: Few risk factors have been identified for nonsyndromic anotia/microtia (A/M).

Methods: We obtained data on cases and a reference population of all livebirths in Texas for 1999-2014 from the Texas Birth Defects Registry (TBDR) and Texas vital records. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for A/M (any, isolated, nonisolated, unilateral, and bilateral) using Poisson regression. We evaluated trends in prevalence rates using Joinpoint regression.

Results: We identified 1,322 cases, of whom 982 (74.3%) had isolated and 1,175 (88.9%) had unilateral A/M. Prevalence was increased among males (PR: 1.3, 95% CI: 1.2-1.4), offspring of women with less than high school education (PR: 1.3, 95% CI: 1.1-1.5), diabetes (PR: 2.0, 95% CI: 1.6-2.4), or age 30-39 versus 20-29 years (PR: 1.2, 95% CI: 1.0-1.3). The prevalence was decreased among offspring of non-Hispanic Black versus White women (PR: 0.6, 95% CI: 0.4-0.8) but increased among offspring of Hispanic women (PR: 2.9, 95% CI: 2.5-3.4) and non-Hispanic women of other races (PR: 1.7, 95% CI: 1.3-2.3). We observed similar results among cases with isolated and unilateral A/M. Sex disparities were not evident for nonisolated or bilateral phenotypes, nor did birth prevalence differ between offspring of non-Hispanic Black and non-Hispanic White women. Maternal diabetes was more strongly associated with nonisolated (PR: 4.5, 95% CI: 3.2-6.4) and bilateral A/M (PR: 5.0, 95% CI: 3.3-7.7). Crude prevalence rates increased throughout the study period (annual percent change: 1.82).

Conclusion: We identified differences in the prevalence of nonsyndromic A/M by maternal race/ethnicity, education, and age, which may be indicators of unidentified social/environmental risk factors.

Keywords: anotia; epidemiology; microtia.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT: The authors have no conflicts of interest to declare.

Figures

FIGURE 1.
FIGURE 1.
Joinpoint trend analysis, crude prevalence of non-syndromic anotia/microtia per 10,000 livebirths, Texas 1999–2014.
See this image and copyright information in PMC

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