Department of Pediatrics, Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Prenat Diagn. 2021 Feb;41(3):341-346. doi: 10.1002/pd.5864. Epub 2020 Nov 16.
The study was designed to assess the impact of socioeconomic barriers on the rate of prenatal diagnosis of critical congenital heart disease (CCHD).
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.
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).
Maternal health, diabetes, socioeconomic factors, and access to sonographers impacts prenatal diagnosis of CCHD.
本研究旨在评估社会经济障碍对先天性心脏病（CCHD）产前诊断率的影响。
这是对 Medicaid 分析提取（MAX）数据集的回顾性研究，该数据集是一个全国性的 Medicaid 行政索赔数据库，具有母婴索赔链接，时间范围为 2007 年至 2012 年。通过搜索分娩日期后 6 个月内的国际疾病分类（ICD）9 代码和先天性心脏病的程序编码系统（PCS）代码，确定患有 CCHD 的婴儿。使用多变量逻辑回归评估母婴和社会经济因素对产前诊断率的影响。
分析中包括 4702 对母婴对。CCHD 的产前诊断率为 27.9%。与 CCHD 产前诊断几率独立相关的因素有母亲患有糖尿病（OR，2.055；P<0.001）、ZIP 编码中位家庭收入（OR，1.005；P=0.015）、超声医师劳动系数（OR，1.804；P=0.047）、分娩年份（OR，1.155；P<0.001）以及获得诊断需要除四腔心或流出道视图以外的其他视图（OR，0.383；P<0.001）。
产妇健康、糖尿病、社会经济因素以及获得超声医师的机会影响 CCHD 的产前诊断。
