O1027: The Impact of Neighborhood Socioeconomic Status, Race and Ethnicity, and Language on Prenatal Diagnosis of Congenital Heart Disease

Background: Congenital heart disease (CHD) is the most prevalent birth defect. Prenatal diagnosis (PD) of CHD is associated with fewer post-delivery medical complications and better neurological outcomes in childhood. Receiving a PD also allows parents to learn more about the type of CHD and the postnatal treatment plan through consultations with their healthcare team. Previous studies have shown that patients with lower socioeconomic status (SES), public insurance, and rural residence are less likely to receive a PD. This study aimed to assess whether PD of CHD and time of the diagnosis are associated with maternal race, ethnicity, neighborhood SES, and language

Methods: In this retrospective cohort study, we analyzed data on163 patients who underwent surgical intervention for CHD within 30 days of birth between 2011 and 2020 at the University of Maryland Children’s Hospital. A neighborhood SES score was calculated using the mother’s address at time of discharge and 6 SES variables from US Census block group data with a previously published method by Diez Roux et al.

Results: Neighborhood SES did not impact the likelihood of receiving a PD of CHD; however, patients of Latino ethnicity were 3.2 times and non-English preferred language patients were 5.1 times more likely to not receive a PD. Patients whose preferred language was non-English language received a prenatal diagnosis 5.3 weeks later, resulting in the PD being made in the third trimester rather than second. Patients from the highest quartile SES received an earlier prenatal diagnosis, although this association was less significant when controlling for insurance type and preferred language.

Conclusion: Significant disparities in prenatal diagnosis of CHD were seen in patients of Latino ethnicity and patients who prefer non-English language. Better understanding of the root causes of these disparities will be important to guide interventions to reduce these disparities.