Journal article
Environmental and Socioeconomic Factors Influence the Live-Born Incidence of Congenital Heart Disease: A Population-Based Study in California
Journal of the American Heart Association, Vol.9(8), pp.e015255-e015255
04/21/2020
DOI: 10.1161/JAHA.119.015255
PMCID: PMC7428546
PMID: 32306820
Abstract
BACKGROUND The development of congenital heart disease (CHD) is multifactorial with genetic and environmental influences. We sought to determine the relationship between socioeconomic and environmental factors with the incidence of CHD among live-born infants in California and to determine whether maternal comorbidities are in the causal pathway. METHODS AND RESULTS This was a population-based cohort study in California (2007-2012). The primary outcome was having significant CHD. Predictors included socioeconomic status and environmental exposure to pollutants determined by U.S. Census data. A social deprivation index and environmental exposure index was assigned based on neighborhood socioeconomic variables, categorized into 4 quartiles. Quartile 1 was the best with the least exposure to pollutants and social deprivation, and quartile 4 was the worst. Multivariate logistic regression and mediation analyses were performed. Among 2 419 651 live-born infants, the incidence of CHD was 3.2 per 1000 live births. The incidence of CHD was significantly higher among those in quartile 4 compared with quartile 1 (social deprivation index: 0.35% versus 0.29%; odds ratio [OR], 1.31; 95% CI, 1.21-1.41; environmental exposure index: 0.35% versus 0.29%; OR, 1.23; 95% CI, 1.15-1.31) after adjusting for maternal race/ethnicity and age and accounting for the relationship between the 2 primary predictors. Maternal comorbidities explained 13% (95% CI, 10%-20%) of the relationship between social deprivation index and environmental exposure index with the incidence of CHD. CONCLUSIONS Increased social deprivation and exposure to environmental pollutants are associated with the incidence of live-born CHD in California. Maternal comorbidities explain some, but not all, of this relationship. These findings identify targets for social policy initiatives to minimize health disparities.
Details
- Title: Subtitle
- Environmental and Socioeconomic Factors Influence the Live-Born Incidence of Congenital Heart Disease: A Population-Based Study in California
- Creators
- Shabnam Peyvandi - Department of Epidemiology and Biostatistics University of California San Francisco Benioff Children's Hospital San Francisco CARebecca J Baer - Department of Pediatrics University of California San Diego La Jolla CAChristina D Chambers - Department of Pediatrics University of California San Diego La Jolla CAMary E Norton - Obstetrics, Gynecology and Reproductive Sciences University of California San Francisco Benioff Children's Hospital San Francisco CASatish Rajagopal - Division of Critical Care University of California San Francisco Benioff Children's Hospital San Francisco CAKelli K Ryckman - Department of Epidemiology College of Public Health University of Iowa Iowa City IAAnita Moon-Grady - Division of Cardiology Department of Pediatrics University of California San Francisco Benioff Children's Hospital San Francisco CALaura L Jelliffe-Pawlowski - California Preterm Birth Initiative University of California San Francisco Benioff Children's Hospital San Francisco CAMartina A Steurer - California Preterm Birth Initiative University of California San Francisco Benioff Children's Hospital San Francisco CA
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.9(8), pp.e015255-e015255
- DOI
- 10.1161/JAHA.119.015255
- PMID
- 32306820
- PMCID
- PMC7428546
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Grant note
- K23 NS099422 / NINDS NIH HHS
- Language
- English
- Date published
- 04/21/2020
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology
- Record Identifier
- 9984214802202771
Metrics
16 Record Views