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Outcomes worse for Hispanic infants with congenital heart diseases

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A study found Hispanic infants born with heart disease have worse outcomes in the first year than those born to white mothers

By Allen Cone, UPI

Hispanic infants born with heart disease have worse outcomes in the first year than those born to white mothers, with researchers linking the finding to the mother's level of education and insurance coverage, according to a study.

Researchers studied two heart defects that require neonatal surgery. With hypoplastic left heart syndrome, the left side of the heart is underdeveloped in the womb, and the aorta and left ventricle are too small. And with d-transposition of the great arteries, two of the main arteries are connected to the wrong side of the heart.

In the case of both, the researchers found less-favorable rates of mortality for Hispanic infants than for non-Hispanic white infants with the same conditions, report report in the new study, published Wednesday in the Journal of the American Heart Association.

Congenital heart disease affects nearly 1 percent of births -- about 40,000 babies -- in the United States each year. About 25 percent them have a critical CHD, and they generally need surgery or other procedures in their first year of life.

"The findings from this paper begin to increase our awareness of non-medical factors that can impact the outcome of children with complex congenital heart disease," Dr. Shabnam Peyvandi, an assistant professor at the University of California, San Francisco, said in a press release.

The research is consistent with other studies. Hispanic infants had less favorable outcomes in one-year mortality or the number of readmissions up to 1 year of age as compared with non-Hispanic white infants with the same defects.

In the latest study, researchers studied the outcomes and key socioeconomic variables from a database maintained by the California Office of Statewide Health Planning and Development. It includes data on 3.1 million live births from the years 2007-12.

The number of live‐born infants with the defects include 1,796 patients, of which 838 were Hispanic patients and 477 were non-Hispanic. The study only included gestational age 22 to 42 completed weeks and researchers excluded those with other major structural birth defects aside from the two they were focused on.

The researchers found Hispanic mothers were younger, had fewer years of education, higher rates of public insurance, lived in cities and their infants were more likely to have been born in community hospitals. Infants born to Hispanic mothers were also found to be smaller for their gestational age.

Only 22 percent of Hispanic mothers had more than 12 years of school, compared with 70 percent for non-Hispanic white mothers. And 69 percent of non-Hispanic white mothers had private insurance coverage compared with 23.5 percent of Hispanic women.

The researchers also note that income, access to care and occupation could have contributed to a large percentage of the disparity.

"This study demonstrates the socioeconomic factors that can in part explain the disparities seen between Hispanic infants with congenital heart disease compared to white infants," Peyvandi said. "Maternal education levels likely act as a proxy for other socioeconomic factors that may impede access to care and available resources to certain communities."

He said this data can be valuable in improving healthcare.
"Community engagement and outreach to at-risk communities are initial steps in identifying specific barriers to healthcare access with a goal of improving outcomes for all children with congenital heart disease," Peyvandi said.

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Health - U.S. Daily News: Outcomes worse for Hispanic infants with congenital heart diseases
Outcomes worse for Hispanic infants with congenital heart diseases
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