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Updated: Jun 8, 2026
Analysis of Congenital Heart Defects in Mouse Embryos Using Qualitative and Quantitative Histological Methods
Published on: March 10, 2020
Racial differences by gestational age in neonatal deaths attributable to congenital heart defects --- United States,
Insights
Congenital heart defects cause significant neonatal mortality. Rates differ by maternal race and gestational age, with higher mortality for Black infants born at term but lower for those born preterm.
Area of Science:
- Pediatrics
- Public Health
- Genetics
Background:
- Congenital heart defects (CHDs) affect ~1% of US births, representing the leading cause of birth defect-related infant mortality.
- CHDs have multifactorial origins, including genetic factors (e.g., DiGeorge syndrome) and maternal risk factors (e.g., diabetes, rubella).
- Neonatal mortality (<28 days) accounts for ~70% of infant deaths from CHDs, with existing data suggesting racial disparities in all-cause neonatal mortality.
Purpose of the Study:
- To investigate neonatal mortality rates attributed to CHDs stratified by maternal race and gestational age.
- To analyze trends in CHD-related neonatal mortality using linked birth and infant death data.
Main Methods:
- Utilized linked U.S. birth and infant death data from 2003–2006, analyzed by the CDC.
- Focused on neonatal deaths where a congenital heart defect was the identified underlying cause.
- Stratified mortality rates by maternal race (Black vs. White) and gestational age (preterm <37 weeks vs. term ≥37 weeks).
Main Results:
- Congenital heart defects were the underlying cause for 4.2% of all neonatal deaths and 24.5% of birth defect-related neonatal deaths.
- Among preterm infants, Black mothers had lower CHD-attributable neonatal mortality rates (4.5/10,000 live births) than White mothers (6.8/10,000).
- Among term infants, Black mothers had higher CHD-attributable neonatal mortality rates (1.5/10,000 live births) than White mothers (1.3/10,000).
Conclusions:
- Neonatal mortality attributable to CHDs exhibits distinct racial disparities that vary by gestational age.
- Further research is needed to understand the underlying reasons for these observed racial and gestational age differences.
- Future studies should examine prenatal diagnosis rates, prevalence at birth, and accurate cause-of-death reporting for CHDs.
Abstract:
Congenital heart defects are diagnosed in approximately 1% of births in the United States and account for the largest proportion of infant mortality attributable to birth defects. Congenital heart defects are multifactorial in origin and have several recognized genetic causes (e.g., DiGeorge and Williams-Beuren syndromes) and noninherited risk factors (e.g., maternal pregestational diabetes and rubella infection). Approximately 70% of infant deaths attributable to congenital heart defects occur neonatally (age <28 days). U.S. studies have shown that all-cause neonatal mortality rates are higher among term infants of black mothers compared with white mothers, but lower among preterm infants of black mothers compared with white mothers. To assess neonatal mortality attributable to congenital heart defects by maternal race and gestational age, CDC analyzed linked U.S. birth and infant death data for 2003--2006. This report summarizes the results of that analysis, which found that 4.2% of all neonatal deaths and 24.5% of neonatal deaths attributable to birth defects had a congenital heart defect noted as the underlying cause. Among preterm births (<37 completed weeks' gestation), neonatal mortality rates attributable to congenital heart defects were lower for blacks (4.5 per 10,000 live births) compared with whites (6.8). However, among term births (≥37 completed weeks' gestation), neonatal mortality rates attributable to congenital heart defects were higher for blacks (1.5 per 10,000 live births) than for whites (1.3). The reasons for these racial differences by gestational age are unclear and will require further examination, including assessment of differences in prenatal diagnosis and prevalence at birth of congenital heart defects, and reporting of causes of death.
