Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease
Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Onta...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-020-03512-8 |
| _version_ | 1818665053915709440 |
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| author | Qun Miao Sandra Dunn Shi Wu Wen Jane Lougheed Jessica Reszel Carolina Lavin Venegas Mark Walker |
| author_facet | Qun Miao Sandra Dunn Shi Wu Wen Jane Lougheed Jessica Reszel Carolina Lavin Venegas Mark Walker |
| author_sort | Qun Miao |
| collection | DOAJ |
| description | Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation. |
| first_indexed | 2024-12-17T05:42:32Z |
| format | Article |
| id | doaj.art-443c0c05e781435f8dd6d0eab851b2b8 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-17T05:42:32Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-443c0c05e781435f8dd6d0eab851b2b82022-12-21T22:01:24ZengBMCBMC Pregnancy and Childbirth1471-23932021-01-0121112110.1186/s12884-020-03512-8Neighbourhood maternal socioeconomic status indicators and risk of congenital heart diseaseQun Miao0Sandra Dunn1Shi Wu Wen2Jane Lougheed3Jessica Reszel4Carolina Lavin Venegas5Mark Walker6BORN OntarioBORN OntarioSchool of Epidemiology and Public Health, University of Ottawa Faculty of MedicineChildren’s Hospital of Eastern Ontario Research InstituteBORN OntarioBORN OntarioBORN OntarioAbstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.https://doi.org/10.1186/s12884-020-03512-8The Better Outcomes Registry & Network (BORN) databaseThe Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD)Congenital heart diseaseSocioeconomic statusImmigrantsMinorities |
| spellingShingle | Qun Miao Sandra Dunn Shi Wu Wen Jane Lougheed Jessica Reszel Carolina Lavin Venegas Mark Walker Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease BMC Pregnancy and Childbirth The Better Outcomes Registry & Network (BORN) database The Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) Congenital heart disease Socioeconomic status Immigrants Minorities |
| title | Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| title_full | Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| title_fullStr | Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| title_full_unstemmed | Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| title_short | Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| title_sort | neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease |
| topic | The Better Outcomes Registry & Network (BORN) database The Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) Congenital heart disease Socioeconomic status Immigrants Minorities |
| url | https://doi.org/10.1186/s12884-020-03512-8 |
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