Ethnic and socioeconomic variation in incidence of congenital heart defects

Abstract

IntroductionEthnic differences in the birth prevalence of congenital heart defects (CHDs) have been reported; however, studies of the contemporary UK population are lacking. We investigated ethnic variations in incidence of serious CHDs requiring cardiac intervention before 1 year of age.MethodsAll infants who had a cardiac intervention in England and Wales between 1 January 2005 and 31 December 2010 were identified in the national congenital heart disease surgical audit and matched with paediatric intensive care admission records to create linked individual child records. Agreement in reporting of ethnic group by each audit was evaluated. For infants born 1 January 2006 to 31 December 2009, we calculated incidence rate ratios (IRRs) for CHDs by ethnicity and investigated age at intervention, antenatal diagnosis and area deprivation.ResultsWe identified 5350 infants (2940 (55.0%) boys). Overall CHD incidence was significantly higher in Asian and Black ethnic groups compared with the White reference population (incidence rate ratios (IRR) (95% CIs): Asian 1.5 (1.4 to 1.7); Black 1.4 (1.3 to 1.6)); incidence of specific CHDs varied by ethnicity. No significant differences in age at intervention or antenatal diagnosis rates were identified but affected children from non-White ethnic groups were more likely to be living in deprived areas than White children.ConclusionsSignificant ethnic variations exist in the incidence of CHDs, including for specific defects with high infant mortality. It is essential that healthcare provision mitigates ethnic disparity, including through timely identification of CHDs at screening, supporting parental choice and effective interventions. Future research should explore the factors underlying ethnic variation and impact on longer-term outcomes.

Association of Maternal Ethnicity and Urbanicity on Severe Pediatric Disease: A Nationwide Cohort Study

“…31 Previous studies revealed ethnic disparities in incidence. [32][33][34] However, we found no significant differences between TBMs and FBMs. Instead, children of rural TBMs had the highest incidence, perhaps because of the higher prevalence of alcohol misuse in rural areas.…”

5‐year experience of a tertiary center in major congenital abnormalities in singleton pregnancies

“…There are also several studies showing that the incidence of congenital abnormalities tend to be decreasing in last decade (Yu et al, ). Ethnic differences may also play a role in the incidences of certain congenital abnormalities (Knowles et al, ).…”

Issues facing families of infants discharged after cardiac surgery: the perceptions of charity helpline staff

“…Participants could also only comment on the support and information needs of families who contacted the helpline, which is likely to result in the needs of some parents not being represented, such as those of parents from non‐English speaking populations or parents who were less able – for financial, social or other reasons – to contact the helpline. From previous work , we know that children from ethnic minorities are over‐represented in the CHD population and yet these are the families who are least likely to access support. A further limitation was that not every participant had experience in each of the areas covered by the interview – for example, one helpline staff member had not taken any calls in relation to discharge after surgery but they had spoken to many parents about sources of support once families were back home.…”

“…There is a wealth of evidence about the psychological impact of the diagnosis of CHD and subsequent treatment on parents , but far less is documented about the specific concerns of parents once their child is discharged from hospital. As part of a larger study looking at infants with complex CHD who have been discharged home, which included interviews with parents and health professionals , we wanted to interview helpline staff from a number of charities providing support to families of children with CHD to understand their experiences of talking to families whose baby had recently been discharged after infant cardiac surgery. We specifically wanted to elicit their perceptions of the key reasons/issues/concerns that families called the helpline to discuss in relation to their baby's cardiac surgery.…”