Neighborhood-level socioeconomic position and mortality among children born with critical congenital heart defects

Sanjida J Mowla; Chantel L Martin; Jeanette A Stingone; Thomas J Luben; Nina E Forestieri; Matthew E Oster; Elizabeth C Ailes; Shannon Pruitt Evans; Sarah C Fisher; Paul A Romitti; Suzan L Carmichael; Philip J Lupo; Anne Marie Darling; Wendy N Nembhard; Andrew F Olshan; Tania A Desrosiers; National Birth Defects Prevention Study

doi:10.1093/aje/kwag078

Back

Neighborhood-level socioeconomic position and mortality among children born with critical congenital heart defects

Journal article

Peer reviewed

Neighborhood-level socioeconomic position and mortality among children born with critical congenital heart defects

Sanjida J Mowla, Chantel L Martin, Jeanette A Stingone, Thomas J Luben, Nina E Forestieri, Matthew E Oster, Elizabeth C Ailes, Shannon Pruitt Evans, Sarah C Fisher, Paul A Romitti, …

American journal of epidemiology

04/17/2026

DOI: 10.1093/aje/kwag078

PMID: 41995389

View Online

Abstract

We examined the role of nSEP on 1-year and 5-year survival among children with critical congenital heart defects (CCHDs). Children with CCHDs in the National Birth Defects Prevention Study (1999-2011) were grouped into univentricular and biventricular defects and linked to vital records for 1-year and 5-year mortality. The Neighborhood Deprivation Index (NDI) classified census-tract nSEP (low [referent], moderate, high deprivation) using maternal periconceptional address. Kaplan-Meier survival curves and log-rank tests evaluated survival differences. Cox proportional hazards regression models estimated crude and adjusted hazard ratios (HRs) and 95% confidence intervals, adjusting for birth years, maternal sociodemographic factors, and residential mobility. Among 2459 children with CCHDs, 1-year survival curves differed by neighborhood deprivation. Survival was lowest among children of mothers living in high vs. low deprivation neighborhoods. In crude analyses, high deprivation was associated with higher 1-year mortality (all CCHDs: 1.58 [1.17, 2.13]; univentricular CCHDs: 1.50 [0.99, 2.26]; biventricular CCHDs: 1.64 [1.02, 2.64]). After adjustment, estimates were generally attenuated and less precise. Five-year survival showed similar trends. Further research could inform strategies to address the structural, environmental, and/or physiological factors associated with a potential reduced survival among children with CCHDs born to mothers in socioeconomically deprived areas.

survival analysis

disparity

early childhood mortality

deprivation

CCHD severity

socioeconomic

neighborhood

critical congenital heart defects

infant mortality

Details

Title: Subtitle: Neighborhood-level socioeconomic position and mortality among children born with critical congenital heart defects
Creators: Sanjida J Mowla - University of North Carolina at Chapel Hill
Chantel L Martin - University of North Carolina at Chapel Hill
Jeanette A Stingone - Columbia University
Thomas J Luben - University of North Carolina at Chapel Hill
Nina E Forestieri - NC Department of Health and Human Services
Matthew E Oster - Centers for Disease Control and Prevention
Elizabeth C Ailes - National Center on Birth Defects and Developmental Disabilities
Shannon Pruitt Evans - National Center on Birth Defects and Developmental Disabilities
Sarah C Fisher - New York State Department of Health
Paul A Romitti - University of Iowa
Suzan L Carmichael - Stanford University
Philip J Lupo - Baylor College of Medicine
Anne Marie Darling - Massachusetts Department of Public Health
Wendy N Nembhard - University of Arkansas for Medical Sciences
Andrew F Olshan - University of North Carolina at Chapel Hill
Tania A Desrosiers - University of North Carolina at Chapel Hill
National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: American journal of epidemiology
DOI: 10.1093/aje/kwag078
PMID: 41995389
NLM abbreviation: Am J Epidemiol
ISSN: 1476-6256
eISSN: 1476-6256
Publisher: Oxford University Press
Grant note: the Centers for Disease Control and Prevention (CDC) to the North Carolina Center for Birth Defects Research and Prevention at the University of North Carolina at Chapel Hill: U01DD001308 CDC cooperative agreements: PA #96043, PA #02081, FOA #DD09-001, FOA #DD13-003, NOFO #DD18-001, and NOFO #DD23-001
This project was supported through funding from the Centers for Disease Control and Prevention (CDC) to the North Carolina Center for Birth Defects Research and Prevention at the University of North Carolina at Chapel Hill (grant number U01DD001308), and CDC cooperative agreements under PA #96043, PA #02081, FOA #DD09-001, FOA #DD13-003, NOFO #DD18-001, and NOFO #DD23-001 to the Centers for Birth Defects Research and Prevention participating in the National Birth Defects Prevention Study (NBDPS) and/or the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS). Sanjida Mowla was supported by the National Institute of Child Health Development #T32 HD52468.
Language: English
Electronic publication date: 04/17/2026
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9985153358502771

Metrics

1 Record Views