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Are there ethnic disparities in risk of preterm birth among infants born with congenital heart defects? §

Authors

  • Wendy N. Nembhard,

    Corresponding author
    1. Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, Florida 33612-3805
    • Dept. of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612-3805
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  • Jason L. Salemi,

    1. Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, Florida 33612-3805
    2. Birth Defects Surveillance Program, Department of Pediatrics, College of Medicine, University of South Florida, 17 Davis Boulevard, Suite 200, MDC 015, Tampa, Florida 33606
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  • Kimberlea W. Hauser,

    1. Birth Defects Surveillance Program, Department of Pediatrics, College of Medicine, University of South Florida, 17 Davis Boulevard, Suite 200, MDC 015, Tampa, Florida 33606
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  • Jennifer L. Kornosky

    1. Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, Florida 33612-3805
    2. Birth Defects Surveillance Program, Department of Pediatrics, College of Medicine, University of South Florida, 17 Davis Boulevard, Suite 200, MDC 015, Tampa, Florida 33606
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  • Presented at the 19th annual meeting of the Society for Pediatric and Perinatal Research, June 20–21, 2006, Seattle, WA.

  • Presented at the 134th annual meeting of the American Public Health Association, November 4–8, 2006, Boston, MA.

  • §

    Presented at the 12th annual Maternal and Child Health Epidemiology Conference, December 8–10, 2006, Atlanta, GA.

  • Presented at the10th annual meeting of the National Birth Defects Prevention Network, February 5–7, 2007, San Antonio, TX.

  • Presented at the 19th annual meeting of the International Society for Environmental Epidemiology, September 5–9, 2007, Mexico City, Mexico.

Abstract

BACKGROUND:

Birth defects and preterm birth (PTB) are leading causes of infant morbidity and mortality in the United States. Infants with birth defects are more likely to be born preterm (<37 weeks), yet the roles of maternal ethnicity and fetal growth in this relationship are unclear. This study aimed to assess the risk of PTB among non-Hispanic (NH) Black, NH-White, and Hispanic infants with congenital heart defects (CHD), adjusting for fetal growth.

METHODS:

Florida Birth Defects Registry data were used to conduct a retrospective cohort study on 14,319 live-born infants with CHDs born January 1, 1998 to December 31, 2002. ORs and 95% CIs were computed for each growth category (small-for-gestational age [SGA], appropriate-for-gestational-age [AGA], and large-for-gestational-age [LGA]) by ethnicity and adjusted for maternal and infant covariates using logistic regression.

RESULTS:

After adjusting for potential confounders, SGA and AGA NH-Black infants with CHDs had increased risk of PTB compared to NH-White infants with CHDs (OR 1.79; 95% CI: 1.40, 2.30 and OR 1.89; 95% CI: 1.68, 2.13, respectively). Hispanic SGA, AGA, and infants with CHDs had no increased risk of PTB compared to NH-White infants.

CONCLUSIONS:

The increased risk of PTB among SGA and AGA NH-Black infants with CHDs is not explained by the overall disparities in risk of PTB between NH-Blacks and NH-Whites. Additional studies are needed to determine the specific subtypes of CHD for which these relationships are present and if these findings are seen among infants with other birth defects. Birth Defects Research (Part A) 79:754–764, 2007. © 2007 Wiley-Liss, Inc.

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