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Effect of Maternal Race, Residential Rurality, and Social Vulnerability on Critical Congenital Heart Defect Risk

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Abstract

The development of a congenital heart defect (CHD) is multifactorial, with many cases having an unknown etiology. This study explored whether maternal race and lived environment were associated with an infant being born with a critical CHD. A cross-sectional, case–control design was conducted utilizing secondary data analysis. The CHD group (N = 199) consisted of infants diagnosed with a critical CHD within the first year of life identified from hospital databases. The non-CHD group (N = 548) was a random sample of infants selected from the state’s vital statistics database. The primary outcome was a critical CHD diagnosis. Maternal race, residential rurality, and the Social Vulnerability Index (SVI) were assessed for associations with a critical CHD using bivariate and multilevel regression models. Bivariate findings reported significance among residential rurality (p < 0.001), SVI ranking overall (p = 0.017), and SVI by theme (theme 1 p =  0.004, theme 2 p < 0.001, theme 3 p = 0.007, and theme 4 p = 0.049) when comparing infants with and without a critical CHD diagnosis. Results of multilevel logistic regression analyses further identified living in a rural residential area compared to urban areas (OR = 7.32; p < 0.001) as a predictor for a critical CHD diagnosis. The findings of lived environmental level associations provides information needed for continued investigation as the burden of a critical CHD continues to impact families, suggesting further research efforts are needed to improve health disparities.

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Acknowledgements

The first author was a participant in the 2022 NLN Scholarly Writing Retreat, sponsored by the NLN/Chamberlain University College of Nursing Center for the Advancement of the Science of Nursing Education

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  1. School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA

    Katie C. Hall, Jennifer C. Robinson, Masoumeh Karimi & Jung Hye Sung

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  1. Katie C. Hall
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  2. Jennifer C. Robinson
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Contributions

K.H. and J.R. were involved in the concept development of the manuscript. K.H., J.R., and M.K. wrote the main manuscript text. M.K. and J.S. ran the analysis and prepared Tables 2 and 3. All authors assisted in the review of the manuscript.

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Correspondence to Katie C. Hall.

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Hall, K.C., Robinson, J.C., Karimi, M. et al. Effect of Maternal Race, Residential Rurality, and Social Vulnerability on Critical Congenital Heart Defect Risk. Pediatr Cardiol (2024). https://doi.org/10.1007/s00246-024-03472-2

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