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Are black and Hispanic infants with specific congenital heart defects at increased risk of preterm birth?

Wendy N Nembhard1, Jason L Salemi, Melissa L Loscalzo

  • 1Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, FL 33612-3805, USA. wnembha@health.usf.edu

Pediatric Cardiology
|May 5, 2009
PubMed

Insights

Infants with congenital heart defects (CHDs) face varying preterm birth (PTB) risks based on maternal race/ethnicity and specific CHDs. Non-Hispanic Black infants with conotruncal CHDs showed the highest PTB risk, highlighting disparities in infant health outcomes.

Area of Science:

  • Public Health
  • Pediatrics
  • Genetics

Background:

  • Congenital heart defects (CHDs) are a primary cause of infant mortality and morbidity.
  • Infants with CHDs have a higher risk of preterm birth (PTB) compared to unaffected infants.
  • Existing data suggest racial/ethnic disparities in PTB rates, but specific risks associated with CHDs across different racial/ethnic groups remain unclear.

Purpose of the Study:

  • To investigate whether the risk of PTB associated with specific CHDs differs among maternal racial/ethnic groups.
  • To identify specific CHDs that confer a disproportionately higher risk of PTB in non-Hispanic (NH) Black and Hispanic infants compared to NH-White infants.

Main Methods:

  • A retrospective cohort study analyzed 14,888 singleton infants diagnosed with 11 specific CHDs.
  • Data were sourced from the Florida Birth Defects Registry (1998-2003) for mothers aged 15-49, including covariates from live birth certificates.
  • Multivariable logistic regression models were used to calculate defect-specific odds ratios (OR) for PTB (20-36 weeks gestation), with statistical significance set at P < 0.002.

Main Results:

  • Non-Hispanic (NH) Black infants with conotruncal CHDs exhibited the highest PTB risk.
  • Specific conotruncal defects (common truncus, transposition of the great vessels, tetralogy of Fallot) showed significantly increased PTB risk in NH-Black infants compared to NH-Whites.
  • Hispanic infants with conotruncal CHDs and NH-Black infants with tricuspid valve atresia/stenosis also demonstrated elevated PTB risks.

Conclusions:

  • Both NH-Black and Hispanic infants with CHDs may experience increased PTB risk, with the magnitude varying by specific CHD type.
  • The findings underscore significant racial/ethnic disparities in PTB risk among infants with CHDs.
  • Further research is warranted to elucidate the underlying etiologies of these observed disparities and inform targeted interventions.

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