Population‐Based Data on Congenital Heart Disease and Stroke

Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

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OP29 The prevalence of congenital heart disease in the UK: a population-based register study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2014-204726.32 ◽

2014 ◽

Vol 68 (Suppl 1) ◽

pp. A17.1-A17

Author(s):

KE Best ◽

E Draper ◽

J Kurinczuk ◽

S Stoianova ◽

D Tucker ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Population Based ◽

Register Study ◽

The Uk

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Letter by Murakami et al Regarding Article, “Risk of Dementia in Adults With Congenital Heart Disease: Population-Based Cohort Study”

Circulation ◽

10.1161/circulationaha.118.036136 ◽

2018 ◽

Vol 138 (15) ◽

pp. 1615-1615

Author(s):

Tomoaki Murakami ◽

Masahiro Shiraishi ◽

Taro Murakami

Keyword(s):

Congenital Heart Disease ◽

Cohort Study ◽

Heart Disease ◽

Congenital Heart ◽

Population Based

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Socioeconomic Mediators of Racial and Ethnic Disparities in Congenital Heart Disease Outcomes: A Population‐Based Study in California

Journal of the American Heart Association ◽

10.1161/jaha.118.010342 ◽

2018 ◽

Vol 7 (20) ◽

Cited By ~ 19

Author(s):

Shabnam Peyvandi ◽

Rebecca J. Baer ◽

Anita J. Moon‐Grady ◽

Scott P. Oltman ◽

Christina D. Chambers ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Ethnic Disparities ◽

Population Based ◽

Racial And Ethnic Disparities ◽

Population Based Study ◽

Disease Outcomes

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Reproductive patterns and pregnancy outcomes in women with congenital heart disease - a Swedish population-based study

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/j.1600-0412.2011.01100.x ◽

2011 ◽

Vol 90 (6) ◽

pp. 659-665 ◽

Cited By ~ 14

Author(s):

ANN JOSEFSSON ◽

KRISTINA KERNELL ◽

NIELS ERIK NIELSEN ◽

MARIE BLADH ◽

GUNILLA SYDSJÖ

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pregnancy Outcomes ◽

Congenital Heart ◽

Population Based ◽

Swedish Population ◽

Population Based Study ◽

Reproductive Patterns

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Abstract 2139: Pregnancy-related Hospitalizations Among Women With Congenital Heart Disease In California: A Population-based Analysis

Circulation ◽

10.1161/circ.116.suppl_16.ii_463-d ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Michelle Gurvitz ◽

Karen K Stout ◽

Mary Canobbio ◽

Andrea Richardson ◽

Ruey Kang Chang

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Post Partum ◽

Mode Of Delivery ◽

Population Based ◽

Specialty Care ◽

Hemodynamic Changes ◽

Discharge Data ◽

California Hospital

Objective: To evaluate pregnancy-related hospitalizations of women with congenital heart disease (CHD) in California Background: It is recommended that women with complex CHD receive specialty care during pregnancy. There is a perception that these women require cesarean section (CS) for cardiac reasons, but hemodynamic changes are often less with a vaginal delivery. There are no population based studies evaluating pregnancy in CHD. Methods: California hospital discharge data from the years 2000–2003 were analyzed. Subjects were chosen by age (12–44 years), diagnosis code for CHD and diagnosis or procedure code related to pregnancy. Among the hospitals, there were 7 self-identified specialized adult CHD centers. Descriptive statistics were used to characterize the population by age, CHD diagnosis (complex or non-complex), insurance, hospital (adult CHD center or not), and outcome (delivery, ante-partum, post-partum condition). Multivariate regression was used to determine predictors for CS. Results: There were 1032 hospitalizations among women age 14–44 years (mean 27.7 years). Hospitalizations occurred at 210 different hospitals, with only 14% at the 7 adult CHD centers. CHD diagnoses were complex in 52% and non-complex in 48%. Among the hospitalization outcomes, 77% were deliveries (66% vaginal, 34% CS), 2% abortive and 21% ante or post partum conditions. CS rates were not statistically different between CHD centers (32%) and non-centers (34%) but were higher than the general population (21%). Women with complex CHD were more likely to have a CS (p=0.005) or an abortive outcome (p<0.001) than those with non-complex CHD. Women with complex CHD were less likely to have a CS at an adult CHD center than those women delivered at non-CHD centers (p=0.005). In regression analyses, complex CHD was the only variable associated with CS. Conclusion: Most data on pregnancy in CHD are from single center studies, however, the majority of women with CHD delivered at non-CHD centers. Overall pregnancy outcomes did not appear different by hospital type, but the rates of CS in women with complex CHD suggests specialty care may affect mode of delivery. Understanding of the outcomes of pregnancy in women with CHD would be enhanced by detailed population-based studies.

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Infective Endocarditis in Children With Congenital Heart Disease

Circulation ◽

10.1161/circulationaha.113.001827 ◽

2013 ◽

Vol 128 (13) ◽

pp. 1412-1419 ◽

Cited By ~ 79

Author(s):

Dinela Rushani ◽

Jay S. Kaufman ◽

Raluca Ionescu-Ittu ◽

Andrew S. Mackie ◽

Louise Pilote ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Infective Endocarditis ◽

Confidence Interval ◽

Cumulative Incidence ◽

Congenital Heart ◽

Large Population ◽

Heart Association ◽

Population Based ◽

Control Analysis

Background— The American Heart Association guidelines for prevention of infective endocarditis (IE) in 2007 reduced the groups of congenital heart disease (CHD) patients for whom antibiotic prophylaxis was indicated. The evidence base in CHD patients is limited. We sought to determine the risk of IE in children with CHD. Methods and Results— We performed a population-based analysis to determine the cumulative incidence and predictors of IE in children (0–18 years) with CHD by the use of the Quebec CHD Database from 1988 to 2010. In 47 518 children with CHD followed for 458 109 patient-years, 185 cases of IE were observed. Cumulative incidence of IE was estimated in the subset of 34 279 children with CHD followed since birth, in whom the risk of IE up to 18 years of age was 6.1/1000 children (95% confidence interval, 5.0–7.5). In a nested case-control analysis, the following CHD lesions were at highest risk of IE in comparison with atrial septal defects (adjusted rate ratio, 95% confidence interval): cyanotic CHD (6.44, 3.95–10.50), endocardial cushion defects (5.47, 2.89–10.36), and left-sided lesions (1.88, 1.01–3.49). Cardiac surgery within 6 months (5.34, 2.49–11.43) and an age of <3 years (3.53, 2.51–4.96; reference, ages 6–18) also conferred an elevated risk of IE. Conclusions— In a large population-based cohort of children with CHD, we documented the cumulative incidence of IE and associated factors. These findings help identify groups of patients who are at the highest risk of developing IE.

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