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. 2021 Feb;41(3):341-346.
doi: 10.1002/pd.5864. Epub 2020 Nov 16.

Socioeconomic barriers to prenatal diagnosis of critical congenital heart disease

Matthew J Campbell  1 , Scott Lorch  2 , Jack Rychik  1 , Michael D Quartermain  1 , Molly Passarella  2 , Peter W Groeneveld  3   4
Affiliations

Socioeconomic barriers to prenatal diagnosis of critical congenital heart disease

Matthew J Campbell et al. Prenat Diagn. 2021 Feb.

Abstract

Objective: The study was designed to assess the impact of socioeconomic barriers on the rate of prenatal diagnosis of critical congenital heart disease (CCHD).

Methods: This was a retrospective review of the Medicaid analytic extract (MAX) dataset, a national Medicaid administrative claims database with linked maternal-infant claims, from 2007 to 2012. Infants with CCHD were identified by searching for International Classification of Diseases (ICD) 9 codes and Procedural Coding System (PCS) codes for CCHD within the first 6 months after the delivery date. Multivariate logistic regression was used to evaluate the effect of maternal and socioeconomic factors on the prenatal diagnosis rate.

Results: There were 4702 mother-infant dyads included in the analysis. The prenatal diagnosis rate of CCHD was 27.9%. Factors independently associated with odds of prenatal diagnosis of CCHD were presence of maternal diabetes (OR, 2.055; P < .001), ZIP code level median household income (OR, 1.005; P = .015), sonographer labor quotient (OR, 1.804; P = .047), the year of the delivery (OR, 1.155; P < .001), and needing a view other than a 4 chamber or outflow tract view to obtain the diagnosis (OR, 0.383; P < .001).

Conclusion: Maternal health, diabetes, socioeconomic factors, and access to sonographers impacts prenatal diagnosis of CCHD.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Inclusions and exclusions
FIGURE 2
FIGURE 2
Routine ultrasound rate and prenatal diagnosis rate. The increasing rate of prenatal diagnosis of critical congenital heart disease correlated with increasing rates of routine ultrasounds in pregnancy
FIGURE 3
FIGURE 3
The Effect of Median Household Income on Prenatal Diagnosis Rate. The unadjusted prenatal diagnosis rate is shown based on increasing median income decile. The prenatal diagnosis rate increases with increasing median income decile
See this image and copyright information in PMC

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