Monday, April 18, 2011

Non-Hispanic black infants born with heart defects are more likely to die within the first five years of life than their non-Hispanic white and Hispanic peers

For certain types of congenital heart abnormalities, Hispanic children as well as non-Hispanic black children fare worse than non-Hispanic white children. Congenital heart defects are malformations in one or more structures of the heart or major blood vessels that occur before birth. They are the most common of all birth defects and the leading cause of death among infants with birth defects. There is a growing body of evidence that minority infants with specific types of heart defects have poorer survival rates in early childhood than non-Hispanic white infants. Non-Hispanic black race/ethnicity is more strongly associated with increased risk of early childhood death than Hispanic race/ethnicity. Overall, non-Hispanic black infants with congenital heart defects have a 32% greater risk of early childhood death than their non-Hispanic white counterparts. In contrast, Hispanic infants with heart defects have no overall increased risk of early childhood death when compared with white infants. The risk of early childhood death is twice as great for non-Hispanic black infants with a reversal in primary connections of the heart's two main blood vessels (known as transposition of the great arteries) as for similarly affected non-Hispanic white infants. The same two-fold increased risk is seen in this group for tetralogy of Fallot, a cyanotic heart defect causing low oxygen levels in the blood. Of the three racial/ethnic groups, non-Hispanic black infants consistently have the lowest survival rates for congenital abnormalities in the septum (wall) separating the left and right sides of the heart. Hispanic children have the lowest survival rate of the three groups for hypoplastic left heart syndrome, a rare defect in which the heart's left side is critically underdeveloped. They are also less likely to survive than non-Hispanic whites when born with pulmonary valve atresia without ventricular septic defect, a condition including absence of the pulmonary valve opening in the heart.

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