Maternal race/ethnicity and survival experience of children with congenital heart disease.
OBJECTIVE
To investigate the existence of racial/ethnic disparity in mortality risk among children with individual congenital heart defects and identify any other risk factors.


METHODS
The study cohort, comprising children born between 1983 and 2006 with a selected congenital heart defect, was matched to death records to ascertain vital status. The birth and maternal risk factors were obtained from birth certificates.


RESULTS
After adjusting for covariates using a multivariate regression model, the risk of mortality was significantly higher in children of non-Hispanic black mothers with transposition of the great arteries (hazard ratio (HR), 1.31; 95% CI, 1.07-1.60), tetralogy of Fallot (HR, 1.34; 95% CI, 1.06-1.69), and coarctation of the aorta (HR, 1.40; 95% CI, 1.10-1.79), compared with children of non-Hispanic white mothers. Time trends analysis examining the mortality risk by survival age and birth period found a significant decrease in 5-year mortality risk from 1983 to 2003 births, with a nearly 50% reduction for hypoplastic left heart syndrome and coarctation of the aorta across 3 maternal racial/ethnic groups examined.


CONCLUSIONS
Our findings may help identify at-risk populations and mortality risk factors and thereby contribute to improved survival and quality of life for these children across the lifespan.
Congenital Malformations Registry, Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, NY; School of Public Health, State University of New York, Albany, NY. Electronic address: wxy01@health.state.ny.us.
Ying
Y
Wang
Gang
G
Liu
Charlotte M
CM
Druschel
Russell S
RS
Kirby
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001017:Aortic Coarctation / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004198:Disease Susceptibility; D005260:Female; D006330:Heart Defects, Congenital / Q000208:ethnology* / Q000401:mortality; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000208:ethnology; D016896:Treatment Outcome; D044465:White People; D055815:Young Adult
CA; CHD; CMR; Coarctation of the aorta; Congenital Malformations Registry; Congenital heart defect; HLHS; HR; Hazard ratio; Hypoplastic left heart syndrome; ICD-9-CM; International Classification of Diseases, Ninth Revision, Clinical Modification; NH; Non-Hispanic; TGA; TOF; Tetralogy of Fallot; Transposition of the great arteries; VSD; Ventricular septal defect