- 作者：Ying Wang ; Gang Liu ; Charlotte M. Druschel ; Russell S. Kirby
- 关键词：CA ; Coarctation of the aorta ; CHD ; Congenital heart defect ; CMR ; Congenital Malformations Registry ; HLHS ; Hypoplastic left heart syndrome ; HR ; Hazard ratio ; ICD-9-CM ; International Classification of Diseases ; Ninth Revision ; Clinical Modification ; NH ; Non-Hispanic ; TGA ; Transposition of the great arteries ; TOF ; Tetralogy of Fallot ; VSD ; Ventricular septal defect
- 刊名：The Journal of Pediatrics
- 出版年：November, 2013
- 年：2013
- 卷：163
- 期：5
- 页码：1437-1442.e2
- 全文大小：699 K
Objective
To investigate the existence of racial/ethnic disparity in mortality risk among children with individual congenital heart defects and identify any other risk factors.Study design
The study cohort, comprising children born between 1983 and 2006 with a selected congenital heart defect, was matched to death records to ascertain vital status. The birth and maternal risk factors were obtained from birth certificates.
Results
After adjusting for covariates using a multivariate regression model, the risk of mortality was significantly higher in children of non-Hispanic black mothers with transposition of the great arteries (hazard ratio (HR), 1.31; 95% CI, 1.07-1.60), tetralogy of Fallot (HR, 1.34; 95% CI, 1.06-1.69), and coarctation of the aorta (HR, 1.40; 95% CI, 1.10-1.79), compared with children of non-Hispanic white mothers. Time trends analysis examining the mortality risk by survival age and birth period found a significant decrease in 5-year mortality risk from 1983 to 2003 births, with a nearly 50% reduction for hypoplastic left heart syndrome and coarctation of the aorta across 3 maternal racial/ethnic groups examined.
Conclusion
Our findings may help identify at-risk populations and mortality risk factors and thereby contribute to improved survival and quality of life for these children across the lifespan.