title: Are there ethnic disparities in risk of preterm birth among infants born with congenital heart defects?
abstract: BACKGROUND
  Birth defects and preterm birth (PTB) are leading causes of infant morbidity and mortality in the United States. Infants with birth defects are more likely to be born preterm (<37 weeks), yet the roles of maternal ethnicity and fetal growth in this relationship are unclear. This study aimed to assess the risk of PTB among non-Hispanic (NH) Black, NH-White, and Hispanic infants with congenital heart defects (CHD), adjusting for fetal growth.
  
  
  METHODS
  Florida Birth Defects Registry data were used to conduct a retrospective cohort study on 14,319 live-born infants with CHDs born January 1, 1998 to December 31, 2002. ORs and 95% CIs were computed for each growth category (small-for-gestational age [SGA], appropriate-for-gestational-age [AGA], and large-for-gestational-age [LGA]) by ethnicity and adjusted for maternal and infant covariates using logistic regression.
  
  
  RESULTS
  After adjusting for potential confounders, SGA and AGA NH-Black infants with CHDs had increased risk of PTB compared to NH-White infants with CHDs (OR 1.79; 95% CI: 1.40, 2.30 and OR 1.89; 95% CI: 1.68, 2.13, respectively). Hispanic SGA, AGA, and infants with CHDs had no increased risk of PTB compared to NH-White infants.
  
  
  CONCLUSIONS
  The increased risk of PTB among SGA and AGA NH-Black infants with CHDs is not explained by the overall disparities in risk of PTB between NH-Blacks and NH-Whites. Additional studies are needed to determine the specific subtypes of CHD for which these relationships are present and if these findings are seen among infants with other birth defects.
authors.affiliation: Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida 33612-3805,USA. wnembha@health.usf.edu
authors.forename: Wendy N
authors.initials: WN
authors.lastname: Nembhard
authors.forename: Jason L
authors.initials: JL
authors.lastname: Salemi
authors.forename: Kimberlea W
authors.initials: KW
authors.lastname: Hauser
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Kornosky
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005865:Gestational Age; D054625:Healthcare Disparities; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D007236:Infant, Small for Gestational Age; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors