The poor health outcomes – specifically, worse survival or more hospital readmissions during the first year of life – seen in Hispanic infants born with heart defects in the U.S. may be tied to their mother's education level and insurance status, a new study suggests.
The study, published Wednesday in the Journal of the American Heart Association, looked at infants born with two types of heart defects: hypoplastic left heart syndrome, a condition that occurs when the left side of the heart doesn't develop properly, and transposition of the great arteries, a condition in which the aorta and pulmonary artery are in the wrong position and the blood can't get enough oxygen to take to other organs.
Recognizing that social and economic factors affect patients' health "is one of the first steps in thinking of ways we can try to minimize these health disparities," said the study's lead author, Dr. Shabnam Peyvandi, a pediatric cardiologist at UCSF Benioff Children's Hospital in San Francisco.
The Centers for Disease Control and Prevention estimates that about 2,210 infants are born with one of these heart defects each year.
Previous studies have found that outcomes for these children vary by race and ethnicity. But race in and of itself cannot explain why this would be the case. So, researchers sought to tease out the underlying socioeconomic factors, such as education level, income and insurance status, that could explain this disparity.
Peyvandi and her colleagues analyzed birth records for the more than 3 million children born in California from 2007 to 2012. From that analysis, 1,315 children were born with one of the two heart defects and met other study criteria, such as gestational age. Within this group, 838 were Hispanic and 477 were non-Hispanic whites.
The initial analysis found that Hispanic babies had a higher death rate or a higher number of hospital readmissions than white babies up to age 1. The second analysis, which aimed to identify reasons for this association, pinpointed maternal education level and health insurance status as key factors. Overall, Hispanic mothers were much more likely to have fewer years of schooling than their white peers. In addition, less than a quarter of Hispanic mothers had private insurance, compared to more than two-thirds of white mothers.
Peyvandi said she hopes the findings motivate health care providers who treat babies with these birth defects to offer more health education and emotional support to Hispanic parents.
She said she would like to see community-based research that looks at resources that could help improve health outcomes among infants with congenital heart defects.
Dr. Satinder K. Sandhu, a pediatric cardiologist at Holtz Children's Hospital in Miami who was not involved in the new study, said she believes the study points to potential opportunities for medical providers and health institutions to improve health outcomes for these babies.
"The parents are not the issue here," said Sandhu, who has studied heart disease for more than 20 years. "They want to do right by their child. The question is, do they have the resources to be able to do it."
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