Perinatal & Pediatric
Racial and Ethnic Disparities in Mortality among Children with Congenital Heart Defects: A Scoping Review Jenil Patel* Jenil Patel Maria D. Politis Elijah H. Bolin Lydia Famuyide Wendy N. Nembhard
Background:
Congenital heart disease (CHDs) are the most common congenital anomalies, and mortality vary by race and ethnicity. This scoping review summarizes studies reporting CHD mortality by race and ethnicity, presenting an integrated summary of mortality metrics including rates, in-hospital mortality, and survival.
Methods:
We reviewed peer-reviewed studies from PubMed and Web of Science (1980–2019) reporting mortality among children under age 18 with CHDs by race and ethnicity. Outcome measures included hazard ratios (HRs), odds ratios (ORs), and Kaplan-Meier survival probabilities.
Results:
In total, 18 studies met inclusion criteria, spanning population-based analyses, post-surgical mortality, and survival probability estimates. Among population-based studies, mortality rates for non-Hispanic (NH) White children with CHDs ranged from 0.4 to 9.1 per 10,000 live births, and from 0.5 to 10.0 for NH Black children. Post-surgical mortality studies showed substantial variability, with rates for NH White children with CHDs from 0.2 to 57.0 per 1,000 and from 0.3 to 63.0 per 1,000 for NH Black children. Cox proportional hazard regression models reported HRs indicating higher mortality risks among NH Black and Hispanic children with CHDs compared to NH White children. In-hospital and survival rates in childhood were also disproportionately lower for NH Black and Hispanic children, as shown by ORs and Kaplan-Meier analyses from US states like Florida and Texas.
Conclusions:
Significant racial and ethnic disparities in mortality was consistently reported for children with CHDs, particularly in post-surgical and in-hospital settings. These findings underscore the need for targeted research to understand disparities and improve equitable healthcare access for CHD-affected populations.