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Fetal growth among infants with congenital heart defects by maternal race/ethnicity
Wendy N Nembhard1, Melissa L Loscalzo
1Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33612-3805, USA. wnembha@health.usf.edu
Insights
Racial and ethnic differences in fetal growth for infants with congenital heart defects (CHDs) are minimal. However, specific CHDs like ventricular septal defect and tetralogy of Fallot showed some variations in large-for-gestational age risks among Black infants.
Area of Science:
- Pediatric Cardiology
- Birth Defects Research
- Neonatal Growth Studies
Background:
- Congenital heart defects (CHDs) are the most common birth defects.
- Infants with CHDs are more likely to be small-for-gestational age (SGA).
- Limited data exists on racial/ethnic variations in SGA and large-for-gestational age (LGA) among infants with CHDs.
Purpose of the Study:
- To determine the risk of SGA and LGA in non-Hispanic (NH)-Black and Hispanic infants with CHDs.
- To investigate racial/ethnic disparities in fetal growth patterns for infants diagnosed with CHDs.
Main Methods:
- Retrospective cohort study utilizing the Florida Birth Defects Registry (1998-2003).
- Inclusion of 10,027 live-born infants with 11 specific CHDs.
- Analysis of SGA and LGA risk by race/ethnicity using multinomial logistic regression, adjusted for covariates.
Main Results:
- No statistically significant racial/ethnic differences were found in the risk of SGA after covariate adjustment.
- NH-Black infants with ventricular septal defect exhibited an increased risk of LGA compared to NH-White infants.
- NH-Black infants with tetralogy of Fallot showed a decreased risk of LGA compared to NH-White infants.
Conclusions:
- Few racial/ethnic disparities in fetal growth exist among infants with CHDs.
- Further research is required to understand the factors influencing fetal growth in CHD cases.
- The impact of CHDs on fetal development warrants additional investigation.
Purpose:
Congenital heart defects (CHDs) are the most prevalent birth defects. Infants with CHDs more often are small-for-gestational age (SGA) than infants without CHD; however, little is known about racial/ethnic variations in prevalence of SGA or large-for-gestational age (LGA) for infants born with CHDs. This study determined the risk of SGA and LGA for non-Hispanic (NH)-black and Hispanic infants with CHDs.
Methods:
Data from the Florida Birth Defects Registry were used in a retrospective cohort study of 10,027 live-born infants to resident NH-White, NH-Black, and Hispanic women ages 15-49 years from January 1, 1998, to December 31, 2003, and diagnosed with 11 CHDs. Defect-specific odds ratios and 95% confidence intervals were computed for risk of SGA and LGA by race/ethnicity and adjusted for covariates using multinomial logistic regression.
Results:
After adjusting for covariates, we found there were no statistically significant racial/ethnic differences in risk of SGA. However, NH-Blacks with ventricular septal defect had increased risk of LGA and NH-Blacks with tetralogy of Fallot had decreased risk of LGA compared to NH-Whites.
Conclusions:
Very few racial/ethnic differences in fetal growth are present among infants with CHD. Further elucidation of the factors involved in fetal growth and the impact of CHD itself on fetal development is needed.
