title: Ethnic and socioeconomic variation in incidence of congenital heart defects.
abstract: Ethnic differences in the birth prevalence of congenital heart defects (CHDs) have been reported; however, studies of the contemporary UK population are lacking. We investigated ethnic variations in incidence of serious CHDs requiring cardiac intervention before 1 year of age.
  
  
  
  All infants who had a cardiac intervention in England and Wales between 1 January 2005 and 31 December 2010 were identified in the national congenital heart disease surgical audit and matched with paediatric intensive care admission records to create linked individual child records. Agreement in reporting of ethnic group by each audit was evaluated. For infants born 1 January 2006 to 31 December 2009, we calculated incidence rate ratios (IRRs) for CHDs by ethnicity and investigated age at intervention, antenatal diagnosis and area deprivation.
  
  
  
  We identified 5350 infants (2940 (55.0%) boys). Overall CHD incidence was significantly higher in Asian and Black ethnic groups compared with the White reference population (incidence rate ratios (IRR) (95% CIs): Asian 1.5 (1.4 to 1.7); Black 1.4 (1.3 to 1.6)); incidence of specific CHDs varied by ethnicity. No significant differences in age at intervention or antenatal diagnosis rates were identified but affected children from non-White ethnic groups were more likely to be living in deprived areas than White children.
  
  
  
  Significant ethnic variations exist in the incidence of CHDs, including for specific defects with high infant mortality. It is essential that healthcare provision mitigates ethnic disparity, including through timely identification of CHDs at screening, supporting parental choice and effective interventions. Future research should explore the factors underlying ethnic variation and impact on longer-term outcomes.
authors.affiliation: Population Policy and Practice Programme, UCL Great Ormond St Institute of Child Health, University College London, London, UK.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Knowles
authors.affiliation: Population Policy and Practice Programme, UCL Great Ormond St Institute of Child Health, University College London, London, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ridout
authors.affiliation: Clinical Operational Research Unit, University College London, London, UK.
authors.forename: Sonya
authors.initials: S
authors.lastname: Crowe
authors.affiliation: Cardiac Unit, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bull
authors.affiliation: Cardiac Unit, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Wray
authors.affiliation: Cardiac Unit, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Tregay
authors.affiliation: Paediatric Cardiology Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Rodney C
authors.initials: RC
authors.lastname: Franklin
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Barron
authors.affiliation: National Institute for Cardiovascular Outcomes (NICOR), London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.affiliation: Paediatric Intensive Care Audit Network (PICANet), Leeds, UK.
authors.forename: Roger C
authors.initials: RC
authors.lastname: Parslow
authors.affiliation: Cardiac Unit, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Brown
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D011204:Poverty Areas; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014852:Wales / Q000453:epidemiology
keywords: Epidemiology; congenital heart disease; ethnicity; record linkage; socio-economic deprivation