Forero-Manzano Mario J, Triana-Palencia Eddy, Figueroa-Rueda Jenny A, Flórez-Rodríguez Claudia X, Castro-Monsalve Javier M, Quintero-Lesmes Doris C, Gamboa-Delgado Edna M
Neumología Pediátrica, Hospital Internacional de Colombia HIC - Instituto Cardiovascular, Fundación Cardiovascular de Colombia, Piedecuesta, Santander, Colombia.
Servicio de Cardiocirugía Pediátrica, Hospital Internacional de Colombia HIC - Instituto Cardiovascular, Fundación Cardiovascular de Colombia, Piedecuesta, Santander, Colombia.
Pediatr Res. 2023 Apr;93(5):1391-1398. doi: 10.1038/s41390-022-02205-6. Epub 2022 Aug 19.
Congenital heart diseases are the most prevalent congenital malformations and cause greater morbi-mortality in newborns and infants. The aim of this study was to analyze the social determinants in families with children with the severity of congenital heart disease.
Analytical cross-sectional study in 140 families of children with congenital heart disease to whom a structured survey was applied addressing topics related to family structure, health, economic conditions, exposure factors, and other social conditions relevant to the study, during 1 year.
In all, 53.7% of the studied population belonged to low socioeconomic levels. No association was found between the severity of the heart disease and the presence of pathological antecedents in the parents. The families resided in urban areas. Also, 28.3% of the mothers had four or fewer prenatal controls during pregnancy. Only 22% of heart diseases were diagnosed during pregnancy. It was found that exposure to cigarette and wood smoke during pregnancy, in addition to low socioeconomic status, was associated with greater severity of heart disease (RACHS-1 and STS-Score), when evaluated by pathophysiological groups (cyanotic/non-cyanotic/single ventricle).
Exposure to cigarette smoke, wood smoke during pregnancy, and low socioeconomic status turned out to be social determinants associated with the severity of heart disease analyzed by pathophysiological groups.
The social component has not been well characterized as a cause of congenital heart disease, especially in countries like ours, where the existence of gaps and social inequities have a high impact. The findings of this study could have an impact on public health to the extent that policies are implemented to reduce exposure to cigarettes, especially during pregnancy. Knowledge of these changes and their measurement in this type of pathology could open the door to the creation of policies aimed at their prevention, focusing on the local risk factors found, which can impact the disease.
先天性心脏病是最常见的先天性畸形，在新生儿和婴儿中导致更高的发病率和死亡率。本研究的目的是分析患有先天性心脏病儿童的家庭中的社会决定因素。
对140名患有先天性心脏病儿童的家庭进行分析性横断面研究，在1年期间对其应用结构化调查问卷，涉及家庭结构、健康、经济状况、暴露因素以及与研究相关的其他社会状况等主题。
总体而言，53.7%的研究人群属于社会经济水平较低者。未发现心脏病严重程度与父母存在病理史之间存在关联。这些家庭居住在城市地区。此外，28.3%的母亲在孕期进行的产前检查次数为四次或更少。仅22%的心脏病在孕期被诊断出来。经病理生理分组（青紫型/非青紫型/单心室）评估发现，孕期接触香烟和木烟，以及社会经济地位低下，均与更严重的心脏病（RACHS - 1和STS评分）相关。
孕期接触香烟烟雾、木烟以及社会经济地位低下被证明是与经病理生理分组分析的心脏病严重程度相关的社会决定因素。
社会因素作为先天性心脏病的一个病因尚未得到充分描述，尤其是在我们这样的国家，存在差距和社会不平等现象且影响巨大。本研究结果可能会对公共卫生产生影响，前提是实施政策以减少接触香烟，尤其是在孕期。了解这些变化及其在这类疾病中的衡量方法，可能会为制定旨在预防这些疾病的政策打开大门，重点关注所发现的当地风险因素，这些因素可能会影响疾病。
