Journal article
Survival of Children With Critical Congenital Heart Defects in the National Birth Defects Prevention Study
Birth defects research, Vol.116(9), e2394
09/2024
DOI: 10.1002/bdr2.2394
PMCID: PMC11548799
PMID: 39258453
Abstract
ABSTRACT Background Critical congenital heart defects (CCHDs) are associated with considerable morbidity and mortality. This study estimated survival of children with nonsyndromic CCHDs and evaluated relationships between exposures of interest and survival by CCHD severity (univentricular or biventricular function). Methods This analysis included 4380 infants with CCHDs (cases) born during 1999–2011 and enrolled in the National Birth Defects Prevention Study, a multisite, population‐based case–control study of major birth defects. Cases were linked to state death files. Nonparametric Kaplan–Meier survival functions were used to estimate 1‐ and 5‐year survival probabilities overall and by severity group (univentricular/biventricular) stratified by demographic and clinical exposure variables of interest. The log‐rank test was used to determine whether stratified survival curves were equivalent. Survival and 95% confidence intervals (CIs) were also estimated using Cox proportional hazards modeling adjusted for maternal age, education, race/ethnicity, study site, and birth year. Results One‐ and five‐year survival rates were 85.8% (CI 84.7–86.8) and 83.7% (CI 82.5–84.9), respectively. Univentricular 5‐year survival was lower than biventricular case survival [65.3% (CI 61.7–68.5) vs. 89.0% (CI 87.8–90.1; p < 0.001)]. Clinical factors (e.g. preterm birth, low birthweight, and complex/multiple defects) were associated with lower survival in each severity group. Sociodemographic factors (non‐Hispanic Black race/ethnicity, <high school education, smoking, and lower household income) were only associated with survival among biventricular cases. Conclusions Mortality among children with CCHDs occurred primarily in the first year of life. Survival was lower for those with univentricular defects, and social determinants of health were most important in predicting survival for those with biventricular defects.
Details
- Title: Subtitle
- Survival of Children With Critical Congenital Heart Defects in the National Birth Defects Prevention Study
- Creators
- Nina E. Forestieri - NC Department of Health and Human ServicesAndrew F. Olshan - University of North Carolina at Chapel HillMatthew E. OsterElizabeth C. Ailes - National Center on Birth Defects and Developmental DisabilitiesMichael P. FundoraSarah C. Fisher - New York State Department of HealthCharles Shumate - Texas Department of State Health ServicesPaul A. Romitti - Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa USARebecca F. Liberman - Massachusetts Department of Public HealthWendy N. NembhardSuzan L. Carmichael - Stanford University School of MedicineTania A. Desrosiers - University of North Carolina at Chapel HillNational Birth Defects Prevention Study
- Resource Type
- Journal article
- Publication Details
- Birth defects research, Vol.116(9), e2394
- DOI
- 10.1002/bdr2.2394
- PMID
- 39258453
- PMCID
- PMC11548799
- NLM abbreviation
- Birth Defects Res
- ISSN
- 2472-1727
- eISSN
- 2472-1727
- Publisher
- Wiley
- Grant note
The authors thank the NBDPS participants. Coding of drug information in the NBDPS used the Slone Drug Dictionary under license from the Slone Epidemiology Center of Boston University. The findings and conclusions in this publication are those of the authors and do not necessarily represent the official position or views of the Centers for Disease Control and Prevention; North Carolina Department of Health and Human Services, Division of Public Health; and California Department of Public Health. The authors also thank Marc Peterson for replicating the analysis.
- Language
- English
- Date published
- 09/2024
- Academic Unit
- Epidemiology; Biostatistics
- Record Identifier
- 9984704832802771
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