Socioeconomic barriers to prenatal diagnosis of critical congenital heart disease. (16th November 2020)

• Record Type: Journal Article
• Authors: Campbell, Matthew J.; Lorch, Scott; Rychik, Jack; Quartermain, Michael D.; Passarella, Molly; Groeneveld, Peter W.
• Is Part Of: Prenatal diagnosis. Volume 41:Number 3(2021)
• Page Start: 341
• Page End: 346
• Publication Date: 2020-11-16
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.5864
• Languages: English
• ISSNs: 0197-3851

Abstract

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.