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Survival of Children With Critical Congenital Heart Defects in the National Birth Defects Prevention Study.
Forestieri, Nina E; Olshan, Andrew F; Oster, Matthew E; Ailes, Elizabeth C; Fundora, Michael P; Fisher, Sarah C; Shumate, Charles; Romitti, Paul A; F Liberman, Rebecca; Nembhard, Wendy N; Carmichael, Suzan L; Desrosiers, Tania A.
Afiliación
  • Forestieri NE; Birth Defects Monitoring Program, State Center for Health Statistics, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA.
  • Olshan AF; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Oster ME; Division of Pediatric Cardiology, Children's Healthcare of Atlanta; and School of Medicine, Emory University, Atlanta, Georgia, USA.
  • Ailes EC; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Fundora MP; Division of Pediatric Cardiology, Children's Healthcare of Atlanta; and School of Medicine, Emory University, Atlanta, Georgia, USA.
  • Fisher SC; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Shumate C; Birth Defects Registry, New York State Department of Health, Albany, New York, USA.
  • Romitti PA; Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA.
  • F Liberman R; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
  • Nembhard WN; Massachussets Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA.
  • Carmichael SL; Department of Epidemiology, College of Public Health; and Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
  • Desrosiers TA; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Birth Defects Res ; 116(9): e2394, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39258453
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiopatías Congénitas Límite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: Birth Defects Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiopatías Congénitas Límite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: Birth Defects Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos