Appendix (A)

States from which data were available in each US census region

US census region / Northeast / South / Midwest / West
States from which data was included in each Region / Connecticut
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rohde Island Vermont / Arkansas
Florida
Maryland
North Carolina
South Carolina
Tennessee
Texas
Virginia / Idaho
Indiana
Kansas
Michigan
Missouri
Nebraska
South Dakota Wisconsin / Arizona
California
Colorado
Utah

Appendix (B)

Sex & race distribution of newborns across US regions 1997-2004, n (%)

Overall US / Northeast / South / Midwest / West
Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females
All Races / 4,143,086 / 2,151,274 (51.9)
1,991,812 (48.1) / 864,65 (20.9) / 450,514 (52.1)
414,137 (47.9) / 1,619,159 (39.1) / 839,317 (51.8)
779,842 (48.2) / 511,219
(12.35) / 265,743 (51.9)
245,476 (48.0) / 1,148,057
(27.70) / 595,700 (51.9)
552,357 (48.1)
Caucasians / 2,370,141
(57.2) / 1,235,032 (52.1)
1,135,109 (47.9) / 588,601 (68.1) / 307,643 (52.3)
280,958 (47.7) / 865,799 (53.5) / 450,942 (52.1)
414,857 (47.9) / 421,218 (82.4) / 219157 (52.0)
202061 (48.0) / 494,523 (43.1) / 257,290 (52)
237,233 (48)
Hispanics / 960,850
(23.2) / 497,493 (51.8)
463,357 (48.2) / 113,449 (13.1) / 59,258 (52.2)
54,191 (47.8) / 346,418 (21.4) / 179,045 (51.7)
167,373 (48.3) / 14,588
(2.8) / 7632 (52.3)
6956 (47.7) / 486,395 (42.4) / 251,558 (51.7)
234,837 (48.3)
AA / 615,266
(14.8) / 315,979 (51.4)
299,287 (48.6) / 121,552 (14.1) / 62,363 (51.3)
59,189 (48.7) / 367,953 (22.7) / 189,121 (51.4)
178,857 (48.6) / 65,306
(12.7) / 33587 (51.4)
31719 (48.6) / 60,455
(5.3) / 30,908 (51.1)
29,547 (48.9)
Asians / 172,742
(4.2) / 90,485 (52.4)
82,257 (47.6) / 33,177 (3.8) / 17,291 (52.1)
15,886 (47.9) / 32,803 (2.0) / 17,043 (52.0)
15,760 (48.0) / 7009
(1.4) / 3723 (53.1)
3286 (46.9) / 99753
(8.7) / 52,428 (52.6)
47,325 (47.4)
Natives / 24,087
(0.58) / 12,285 (51.0)
11,802 (49.0) / 7872 (0.9) / 3959 (50.3)
3913 (49.7) / 6186 (0.4) / 3166 (51.2)
3020 (48.8) / 3098
(0.6) / 1644 (53.1)
1454 (46.9) / 6931
(0.6) / 3516 (50.7)
3415 (49.3)

Appendix(C)

Distribution of CDH in newborns by sex & race across US regions, 1997 - 2004
N, (%; compared to total number of newborns of same race, sex & birth region)
Overall US / Northeast / South / Midwest / West
Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females
All Races / 1291 (0.031)
(1:3200) / 732 (0.034)
559 (0.028) / 195 (0.022)
(1:4400) / 113 (0.03)
82 (0.02) / 525 (0.032)
(1:3100) / 305 (0.036)
220 (0.028) / 152 (0.030)
(1:3400) / 81 (0.030)
71 (0.029) / 419 (0.036)
(1:2700) / 233 (0.039)
186 (0.034)
Caucasians / 744 (0.031)
(1:3200) / 429 (0.035)
315 (0.028) / 143 (0.024) / 86 (0.028)
57 (0.020) / 297 (0.034) / 181 (0.040)
116 (0.028) / 124 (0.029) / 64 (0.029)
60 (0.030) / 180 (0.037) / 98 (0.038)
82 (0.034)
Hispanics / 344 (0.036)
(1:2800) / 190 (0.038)
154 (0.033) / 22 (0.019) / 10 (0.017)
12 (0.022) / 134 (0.039) / 75 (0.042)
59 (0.035) / 4 (0.027) / 2 (0.026)
2 (0.029) / 184 (0.038) / 103 (0.041)
81 (0.034)
AA / 150 (0.024)
(1:4200) / 80 (0.025)
70 (0.023) / 20 (0.009) / 9 (0.014)
11 (0.018) / 85 (0.023) / 43 (0.023)
42 (0.023) / 19 (0.029) / 14 (0.042)
5 (0.016) / 26 (0.043) / 14 (0.045)
12 (0.041)
Asians / 42 (0.024)
(1:4200) / 26 (0.029)
16 (0.019) / 8 (0.024) / 6 (0.034)
2 (0.012) / 9 (0.027) / 6 (0.035)
3 (0.019) / 2 (0.028) / 0 (0.0)
2 (0.060) / 23 (0.023) / 14 (0.027)
9 (0.019)
Natives / 11 (0.046)
(1:2200) / 7 (0.057)
4 (0.034) / 2 (0.025) / 2 (0.056)
0 (0.0) / 0 (0.0) / 0 (0.0)
0 (0.0) / 3 (0.096) / 1 (0.061)
2 (0.137) / 6 (0.086) / 4 (0.114)
2 (0.058)
Odds ratios of females for CDH compared to males in each race across US regions
Overall US / Northeast / South / Midwest / West
All Races / 1.2 (1.1-1.4) P<.001 / P= 0.11 / 1.29 (1.1-1.5) P = 0.005 / P= 0.80 / P = 0.13
Caucasians / 1.25 (1.1-1.4) P=0.003 / P= 0.07 / 1.44 (1.1-1.8) P = 0.003 / P= 0.92 / P= 0.55
AA / P= 0.68 / P= 0.66 / P= 0.91 / P= 0.07 / P= 0.84
Hispanics / P= 0.21 / P= 0.53 / P= 0.34 / P= 0.92 / P= 0.27
Asians / P= 0.28 / P= 0.29 / P= 0.51 / P= 0.50 / P= 0.53
Natives / P= 0.55 / P= 0.50 / N/A / P= 0.60 / P= 0.69
Odds Ratios of AA, Hispanics, Asians or Natives for CDH compared to Caucasians across US region
Overall US / Northeast / South / Midwest / West
AA / 0.78 (0.7-0.9) P=0.004 / P= 0.12 / 0.67 (0.5-0.8) P=0.001 / P= 1.00 / P= 0.43
Hispanics / 1.14 (1.0-1.3) P=0.05 / P= 0.39 / P= 0.26 / P= 1.00 / P= 0.71
Asians / P= 0.12 / P= 0.98 / P= 0.64 / P= 0.97 / 0.6 (0.4-0.9) P= 0.04
Natives / P= 0.19 / P= 0.72 / P= 0.28 / P= 0.06 / P= 0.45

Appendix (D)

Distribution of AWD across sex, race & US regions among newborns 1997-2004,
N, (%; compared to total number of newborns of same race, sex & birth region)
Overall US / Northeast / South / Midwest / West
Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females
All Races / 2184 (0.052)
(1:1900) / 1152 (0.053)
1032 (0.052) / 264 (0.030)
(1:3300) / 147 (0.035)
117 (0.028) / 984 (0.061)
(1:1600) / 540 (0.064)
444 (0.057) / 323 (0.063)
(1:1600) / 149 (0.056)
174 (0.071) / 613 (0.053)
(1:1900) / 316 (0.053)
297 (0.054)
Caucasians / 1266 (0.053)
(1:1900) / 673 (0.054)
593 (0.052) / 178 (0.030) / 100 (0.032)
78 (0.028) / 565 (0.065) / 312 (0.069)
253 (0.061) / 267 (0.063) / 123 (0.056)
144 (0.071) / 256 (0.052) / 138 (0.054)
118 (0.050)
Hispanics / 615 (0.064)
(1:1600) / 320 (0.064)
295 (0.064) / 44 (0.039) / 20 (0.034)
24 (0.044) / 266 (0.077) / 152 (0.085)
114 (0.068) / 13 (0.089) / 4 (0.052)
9 (0.129) / 292 (0.060) / 144 (0.057)
148 (0.063)
AA / 227 (0.045)
(1:2200) / 120 (0.038)
107 (0.036) / 33 (0.027) / 23 (0.037)
10 (0.017) / 139 (0.038) / 70 (0.037)
69 (0.038) / 29 (0.044) / 14 (0.042)
15 (0.047) / 26 (0.043) / 13 (0.042)
13 (0.044)
Asians / 45 (0.026)
(1:3800) / 24 (0.026)
21 (0.025) / 4 (0.012) / 2 (0.016)
2 (0.013) / 13 (0.040) / 5 (0.029)
8 (0.050) / 4 (0.057) / 3 (0.080)
1 (0.030) / 24 (0.024) / 14 (0.026)
10 (0.021)
Natives / 31 (0.129)
(1:800) / 15 (0.122)
16 (0.135) / 5 (0.063) / 2 (0.050)
3 (0.076) / 1 (0.016) / 1 (0.032)
0 (0.0) / 10 (0.322) / 5 (0.304)
5 (0.344 / 15 (0.216) / 7 (0.199)
8 (0.234)
Odds ratios of females for AWD compared to males in overall and in each US regions in all races
Overall US / Northeast / South / Midwest / West
All Races / P= 0.45 / P= 0.27 / P= 0.59 / 0.79 (0.6-0.9) P= 0.039 / P= 0.87
Caucasians / P= 0.46 / P= 0.33 / P= 0.14 / P= 0.06 / P= 0.57
AA / P= 0.69 / 2.18 (1-5) P= 0.037 / P= 0.86 / P= 0.85 / P= 0.91
Hispanics / P= 0.90 / P= 0.45 / P= 0.08 / P= 0.16 / P= 0.41
Asians / P= 0.89 / P= 0.93 / P= 0.41 / P= 0.62 / P= 0.68
Natives / P= 0.85 / P= 0.68 / N/A / P= 0.85 / P= 0.80
Odds Ratios of AA, Hispanics or Natives for AWD compared to Caucasians in overall and each US region
Overall US / Northeast / South / Midwest / West
Afr. Amer. / 0.69 (0.6-0.8) P<0.001 / P=0.64 / 0.58 (0.5-0.7) P<0.001 / P=0.07 / P=0.44
Hispanics / 1.19 (1.1-1.3) P<0.001 / P=0.14 / 1.17 (1.0-1.4) P=0.031 / P=0.24 / P=0.08
Asians / 0.49 (0.4-0.7) P<0.001 / P=0.07 / P=0.07 / P=0.83 / 0.46 (0.3-0.7) P<0.001
Natives / 2.41 (1.7-3.4) P<0.001 / P=0.09 / P=0.20 / 5.1 (2.7-9.6) P<0.001 / 4.19 (2.5-7.1) P<0.001

Appendix (E)

Distribution of NTD across sex, race & US regions among newborns 1997-2004, n (%)
N, (%; compared to total number of newborns of same race, sex & birth region)
Overall US / Northeast / South / Midwest / West
Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females / Total / Males/
Females
All Races / 979 (0.024)
(1:4200) / 491 (0.023)
488 (0.024) / 120 (0.014)
(1:7200) / 48 (0.011)
72 (0.017) / 451 (0.028)
(1:3600) / 238 (0.028)
213 (0.027) / 152 (0.030)
(1:3400) / 82 (0.031)
70 (0.028) / 256 (0.022)
(1:4500) / 123 (0.021)
133 (0.024)
Caucasians / 553 (0.023)
(1:4300) / 264 (0.021)
289 (0.025) / 73 (0.012) / 24 (0.008)
49 (0.017) / 234 (0.027) / 116 (0.026)
118 (0.028) / 134 (0.032) / 75 (0.034)
59 (0.029) / 112 (0.023) / 49 (0.019)
63 (0.026)
Hispanics / 297 (0.032)
(1:3100) / 157 (0.032)
140 (0.030) / 16 (0.014) / 7 (0.012)
9 (0.017) / 143 (0.041) / 84 (0.047)
59 (0.035) / 7 (0.048) / 2 (0.026)
5 (0.071) / 131 (0.027) / 64 (0.025)
67 (0.028)
AA / 116 (0.019)
(1:5300) / 62 (0.020)
54 (0.018) / 27 (0.022) / 15 (0.024)
12 (0.020) / 71 (0.019) / 36 (0.019)
35 (0.019) / 10 (0.015) / 5 (0.015)
5 (0.016) / 8 (0.013) / 6 (0.019)
2 (0.007)
Asians / 11 (0.006)
(1:16,700) / 7 (0.008)
4 (0.005) / 4 (0.012) / 2 (0.012)
2 (0.013) / 3 (0.009) / 2 (0.012)
1 (0.006) / 1 (0.014) / 0 (0.0)
1 (0.030) / 3 (0.003) / 3 (0.006)
0 (0.0)
Natives / 2 (0.008)
(1:12,500) / 1 (0.008)
1 (0.008) / 0 (0.0) / 0 (0.0)
0 (0.0) / 0 (0.0) / 0 (0.0)
0 (0.0) / 0 (0.0) / 0 (0.0)
0 (0.0) / 2 (0.029) / 1 (0.028)
1 (0.029)
Odds ratios of females for NTD compared to males in overall and in each US regions in all races
Overall US / Northeast / South / Midwest / West
All Races / P= 0.27 / 0.61(0.4-0.9) P= 0.01 / P= 0.70 / P= 0.68 / P = 0.23
Caucasians / 0.84 (0.7-0.9) P= 0.04 / 0.45 (0.3-0.7) P0.001 / P= 0.47 / P= 0.39 / P = 0.09
AA / P= 0.71 / P= 0.70 / P= 0.91 / P= 0.93 / P = 0.29
Hispanics / P= 0.73 / P= 0.62 / P= 0.09 / P= 0.27 / P = 0.54
Asians / P= 0.55 / P= 0.93 / P= 0.61 / N/A / N/A
Natives / P= 0.98 / N/A / N/A / N/A / P = 0.98
Odds Ratios of AA, Hispanics or Natives for NTD compared to Caucasians in overall and each US region
Overall US / Northeast / South / Midwest / West
Afr. Amer. / 0.81 (0.7-0.9) P=0.035 / 1.79 (1.2-2.8) P=0.012 / 0.71 (0.5-0.9) P=0.012 / 0.48 (0.3-0.9) P=0.019 / P=0.18
Hispanics / 1.33 (1.2-1.5) P<0.001 / P= 0.66 / 1.52 (1.2-1.9) P<0.001 / P= 0.24 / P=0.17
Asians / 0.27 (0.2-0.5) P<0.001 / P= 0.95 / P= 0.05 / P= 0.73 / 0.13 (0.04-0.4) P<0.001
Natives / P=0.19 / P= 0.97 / P= 0.42 / P= 0.92 / P=0.67