Socioeconomic Factors Associated with Fetal Tachyarrhythmia Management and Outcomes: A Single-Center Retrospective...

Data regarding fetal tachyarrhythmia outcomes are based upon observational studies without consistent protocols and without evaluating socioeconomic variables. The objective of this study is to evaluate the impact of socioeconomic variables on fetal tachyarrhythmia management and outcomes in patients managed with a consistent protocol. This is a single-center retrospective observational study including fetal patients 2014-2024. Patients without significant congenital heart disease had sustained fetal tachyarrhythmia confirmed by echocardiography and treated using the center's protocol. Socioeconomic variables included race, insurance, and area deprivation indices (ADI). Standard statistics were applied. Thirty-two patients were included. Mean gestational age was 29.6 ± 4.6 weeks. Twenty-three patients had supraventricular tachycardia (SVT) and 9 had atrial flutter (AFl). Twelve were White, 11 were Black, 2 were Asian, and 7 were multi-racial/other. Nineteen had private and 13 had government insurance. SVT was successfully treated without readmission in 18/23 or early delivery due to arrhythmia in 18/21; Afl was treated without readmission in 7/9 or early delivery in 6/9. Arrhythmia diagnosis was not related to outcome or SES. Non-white patients trended to be more likely to be delivered early for any reason compared to White patients (13/19 vs. 4/11, p = 0.08), but not for arrhythmia alone. There was a slight trend toward early deliveries being more likely to be via caesarean section in non-White patients, although not statistically significant (12/13 vs. 2/4, p = 0.12). Early deliveries for any reason were more likely to be via caesarean section in those with private insurance (10/10 vs. 4/7, p = 0.05). Socioeconomic variables impact obstetrical decisions for patients with fetal tachyarrhythmia, but not arrhythmia management.