Is the Prevalence of Specific Types of Congenital Heart Defects Different for Non-Hispanic White, Non-Hispanic Black and Hispanic Infants?

Abstract

Background Our purpose was to determine the prevalence of specific types of CHD among non-Hispanic (NH)-Black, NH-White, and Hispanic infants. Methods We conducted a retrospective cohort study with 9,352 singleton infants diagnosed with conotruncal, right or left obstructive or septal CHDs from the Florida Birth Defects Registry, born 1998-2003 to resident NH-White, NH-Black, and Hispanic women aged 15-49. Defect-specific prevalence rates, prevalence ratios and P-values were calculated for each type of CHD and by number of defects for each racial/ ethnic group. Results Compared to NH-Whites, NH-Blacks had higher rates of pulmonary valve atresia/stenosis but lower frequency of aortic valve atresia/stenosis and ventricular septal defect. Hispanics had lower rates of aortic valve atresia/stenosis and atrioventricular septal defects than NH-Whites. Conclusions Although few racial/ethnic differences in prevalence are present among infants with major CHD, observed differences are clinically meaningful. However, the underlying etiologies for the observed differences remain unknown.

Patterns in the prevalence of congenital heart defects, metropolitan Atlanta, 1978 to 2005

“…The increase in prevalence of total CHDs, driven by septal defects, has been reported previously (Wilson et al, 1993;Botto et al, 2001;Oyen et al, 2009;Nembhard et al, 2010). We found that muscular VSDs were the biggest contributor to the increase in prevalence of septal defects and of total CHDs, a finding consistent with an earlier observation (Lewis et al, 1996).…”

“…Our findings corroborate other studies that found lower prevalence among blacks than whites for some left-sided obstructive lesions [e.g., coarctation of the aorta (Hernandez et al, 1969;Correa-Villasenor et al, 1991;Botto et al, 2001;McBride et al, 2005) and aortic stenosis (Correa-Villasenor et al, 1991;Fixler et al, 1993;Nembhard et al, 2010)]. Reports of racial/ethnic differences in prevalence of right-sided lesions have been more limited, suggesting a lower prevalence among blacks compared with whites for Ebstein anomaly and inconsistent findings for pulmonary atresia/ stenosis (Correa-Villasenor et al, 1991;Nembhard et al, 2010). We observed no differences between whites and blacks in prevalence for these two lesions.…”

“…Similar to the earlier MACDP study (Botto et al, 2001), we noted that from 1995 onward, NH-blacks had a significantly lower prevalence of total CHDs and a slower rate of increase in VSD prevalence compared with NH-whites. While others have also noted a lower prevalence of VSDs among blacks compared with whites (Fixler et al, 1993;Nembhard et al, 2010), in our study this trend was specific to the muscular VSD subtype. Our findings corroborate other studies that found lower prevalence among blacks than whites for some left-sided obstructive lesions [e.g., coarctation of the aorta (Hernandez et al, 1969;Correa-Villasenor et al, 1991;Botto et al, 2001;McBride et al, 2005) and aortic stenosis (Correa-Villasenor et al, 1991;Fixler et al, 1993;Nembhard et al, 2010)].…”

“…Since the 1970s, several studies have reported an increase in the birth prevalence of total CHDs and specific phenotypes (e.g., ventricular septal defects [VSDs] and atrial septal defects [ASDs]), with little change in the prevalence of other phenotypes (e.g., coarctation of the aorta) (Wren et al, 2000;Botto et al, 2001;Oyen et al, 2009). Racial/ethnic differences in the birth prevalence of CHDs have also been observed but vary across studies in direction, magnitude, and phenotypes (Hernandez et al, 1969;Correa-Villasenor et al, 1991;Fixler et al, 1993;Botto et al, 2001;McBride et al, 2005;Canfield et al, 2006;Freeman et al, 2008;Nembhard et al, 2010). Until recently, evaluations of CHD birth prevalence among Hispanics have been limited by lack of population-based surveillance data.…”

Birth defects among a cohort of infants born to HIV-infected women on antiretroviral medication

“…In the current study, cardiac septal defects were common but the rate of septal defects was not significantly different by trimester of exposure. The rate of ventricular septal defects, 0.6%, was slightly higher than the rates of 0.25–0.5% reported in the literature, again likely related to increased ascertainment related to study participation [2, 14]. Of note, the prevalence of congenital heart disease has been found to be increasing in the US overall, most likely due to improved ascertainment [2].…”