<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022021000200088</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Mortalidad infantil por defectos congénitos en Costa Rica: actualización 2010-2018]]></article-title>
<article-title xml:lang="en"><![CDATA[Infant mortality due to congenital defects in Costa Rica: 2010-2018 update]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barboza-Argüello]]></surname>
<given-names><![CDATA[María de la Paz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benavides-Lara]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud Unidad de Enfermedades Congénitas Centro de Registro de Enfermedades Congénitas]]></institution>
<addr-line><![CDATA[Tres Ríos Cartago]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>63</volume>
<numero>2</numero>
<fpage>88</fpage>
<lpage>96</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022021000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022021000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022021000200088&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo.  El objetivo de este estudio fue identificar la tendencia de los diferentes tipos de defectos congénitos en la tasa de mortalidad infantil y neonatal en Costa Rica durante el período 2010-2018 con respecto al primer período 2000-2009.  Métodos.  Se realizó un análisis de estadísticas vitales. La fuente de información fue el Instituto Nacional de Estadísticas y Censos de Costa Rica, mediante su sistema de acceso público y consulta en línea, se consultó la base de defunciones por causa y la base de nacimientos para el período 2000-2018. Las causas de defunción por defectos congénitos se agruparon por sistemas, además se seleccionaron los defectos de mayor mortalidad en el periodo de estudio para su análisis específico. Para describir el comportamiento de la mortalidad infantil por defectos congénitos de 2010-2018 con respecto al decenio anterior, se calcularon tasas de mortalidad infantil y neonatal para los períodos 2000- 2009 y 2010-2018 con su respectivo intervalo de confianza (IC95%). Se construyó un modelo de regresión Poisson Log lineal para cada grupo de defectos congénitos y para los defectos específicos seleccionados, tomando como factor de ajuste los subperíodos comparados. Se estimaron razones de prevalencias y se compararon mediante chi cuadrado de Wald usando como base el período 2000-2009.  Resultados.  En las últimas dos décadas, los defectos congénitos causaron 29% a 38% de la mortalidad infantil general. La tasa de mortalidad infantil por defectos congénitos durante 2000-2009 fue 3,19 (IC95%: 3,1-3,3) y descendió significativamente a 2,97 (IC95%: 2,8-3,1) en el período 2010-2018. Esta disminución se dio a expensas de la afectación de los sistemas circulatorio y digestivo.Al analizar la mortalidad infantil por defectos congénitos específicos, se demostró una disminución significativa únicamente en espina bífida y algunos defectos cardiacos: transposición de grandes arterias, defecto septal ventricular, coartación aorta y otras anomalías cardiacas no especificadas. La tasa de mortalidad neonatal por defectos congénitos no varió significativamente entre los períodos comparados, en 2000-2009 fue 2,13 (IC95%: 2,0-2,2) y 2,17 (IC95%: 2,1-2,3) en 2010-2018. El único grupo de defectos congénitos que presentó una disminución significativa en la tasa de mortalidad neonatal en la última década fue el sistema circulatorio.  Conclusiones.  En la última década se presentó una disminución significativa de la tasa de mortalidad infantil por defectos congénitos. Este descenso obedeció principalmente a una disminución significativa en las tasas de mortalidad infantil y neonatal por defectos cardiacos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective. This study aims to identify the trend of the different types of congenital defects in the infant and neonatal mortality rate in Costa Rica during the period 2010- 2018, and to compare it with the period 2000-2009.  Methods.  A vital statistics analysis was performed. The source of information was the Costa Rican National Institute of Statistics and Censuses, through its public domain system and online consultation, the base of deaths by cause and the base of births for the period 2000-2018 were consulted. The causes of death due to congenital defects were grouped by system, in addition, the defects with the highest mortality in the study period were selected for their specific analysis. To describe the behavior of infant mortality due to congenital defects in 2010-2018 with respect to the previous decade, infant and neonatal mortality rates were calculated for the periods 2000-2009 and 2010- 2018 with their respective confidence interval (95% CI). A linear Poisson Log regression model was constructed for each group of congenital defects and for the specific defects selected, taking the sub periods compared as an adjustment factor. Prevalence ratios were estimated and compared using Wald&#8217;s chi square based on the period 2000-2009.  Results.  In the last two decades, birth defects caused 29% to 38% of overall infant mortality. The infant mortality rate due to congenital defects during 2000-2009 was 3.19 (95% CI: 3.06-3.32) and presented a significant decrease to 2.97 (95% CI: 2.84-3.11) in the 2010-2018 period. This decrease occurred at the expense of the affection of circulatory and digestive systems. When analyzing infant mortality due to specific congenital defects, a significant decrease was shown only in spina bifida and some cardiac defects: transposition of the great arteries, ventricular septal defect, aortic coarctation and other unspecified cardiac anomalies. The neonatal mortality rate due to congenital defects did not vary significantly between the periods compared, in 2000-2009 it was 2.13 (95% CI: 2.03-2.24) and 2.17 (95% CI: 2.06-2, 29) in 2010-2018. The only group of congenital defects that presented a significant decrease in the neonatal mortality rate in the last decade was the circulatory system.  Conclusions.  In the last decade there was a significant decrease in the infant mortality rate due to congenital defects. This decrease was mainly due to a significant decrease in infant and neonatal mortality rates from heart defects.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[mortalidad infantil]]></kwd>
<kwd lng="es"><![CDATA[defectos congénitos]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
<kwd lng="en"><![CDATA[Infant mortality]]></kwd>
<kwd lng="en"><![CDATA[neonatal mortality]]></kwd>
<kwd lng="en"><![CDATA[birth defects]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
</kwd-group>
</article-meta>
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