Socioeconomic and racial disparities in the prevalence of congenital heart disease in infants of diabetic mothers

Abstract

Infants of diabetic mothers (IDM) are at increased risk for congenital heart disease (CHD). There is little information in the literature about the impact of economic status and race/ethnicity on the prevalence of CHD in IDM. Using the KID national database collected from 2003 to 2012, we studied over 180,000 IDM to compare the prevalence of CHD according to family income and race/ethnicity. There were 9214 (5.02%) CHDs out of 183 453 IDM. We found significant impact of family income and race/ethnicity on the prevalence of CHD. Specifically, compared to IDM born in a family with highest 25th quartile family income, infants in the lowest 25th quartile family income had higher odds of CHD with unadjusted odds ratio (OR) of 1.6 [(95% confidence interval (CI): 1.4–1.7), p < .001]. In terms of racial/ethnic differences, Black [unadjusted OR = 1.4 (95% CI: 1.3–1.5), p < .001] and Hispanic [unadjusted OR 1.26 (95% CI: 1.2–1.4), p < .001] IDM are more likely, and Asians [0.69 (95% CI: 0.59–0.81), p < .001] were less likely to have CHD when compared to whites. When adjusting race/ethnicity for family income quartile and vice versa, we did not observe changes in the estimates, suggesting that family income and race/ethnicity impact on the odds of CHD independently. Our report of higher prevalence of CHD among IDM in ethnic minorities and lower socioeconomic status would warrant more studies to further dissect causes of higher prevalence in these subpopulations.