Dorsey Amanda N, Downing Karrie F, Deputy Nicholas P, Weber Mary Kate, Howards Penelope P
Emory University, Department of Epidemiology, 1518 Clifton Rd NE, Atlanta, GA, USA; National Center on Birth Defects and Developmental Disabilities, CDC, 4770 Buford Hwy, Atlanta, GA, USA; G2S Corporation, Shavano Park, TX, USA.
National Center on Birth Defects and Developmental Disabilities, CDC, 4770 Buford Hwy, Atlanta, GA, USA.
Drug Alcohol Depend. 2025 Sep 1;274:112790. doi: 10.1016/j.drugalcdep.2025.112790. Epub 2025 Jul 12.
Alcohol use during pregnancy might be a risk factor for some congenital heart defects (CHDs), but CHD prevalence among children with fetal alcohol spectrum disorders (FASDs) is not well understood. We used two administrative databases to explore CHD prevalence among U.S. children with and without FASDs.
We limited 2016-2022 Merative™ MarketScan® Multi-State Medicaid and Commercial data to children ≤ 17 years old with ≥ 1 year of continuous enrollment with complete data on mental health and substance use services. CHD prevalence was calculated by FASD status, overall and by age group, using log-binomial prevalence ratios (PRs) and 95 % confidence intervals (CIs). Analyses were repeated after matching on enrollment length, and age and year at the start of enrollment. In the Medicaid sample, we also stratified by demographic characteristics and analyzed severe and non-severe CHD diagnoses separately. Multidimensional bias analysis considered the influence of unmeasured prenatal tobacco exposure.
Among 8732,345 children in the Medicaid sample, 5.2 % with FASDs and 1.0 % without FASDs had CHDs (matched cohort PR = 3.4 [CI: 2.8, 4.1]). PRs were similar when stratified by sex and race and ethnicity, and when looking at exclusively severe or non-severe CHDs. Among 10,567,765 children in the commercial claims sample, 3.0 % with FASDs and 0.6 % without FASDs had CHDs (matched cohort PR= 4.6 [CI: 3.3, 6.4]).
CHDs were more common among children with FASDs compared to those without FASDs in two administrative database samples. Increased provider awareness about CHDs as a potential FASD comorbidity may improve timely CHD care.
孕期饮酒可能是某些先天性心脏病（CHD）的危险因素，但胎儿酒精谱系障碍（FASD）患儿的CHD患病率尚不清楚。我们使用两个行政数据库来探究美国患有和未患有FASD的儿童的CHD患病率。
我们将2016 - 2022年Merative™ MarketScan®多州医疗补助和商业数据限制在17岁及以下、连续参保≥1年且有心理健康和物质使用服务完整数据的儿童。根据FASD状态、总体情况和年龄组，使用对数二项患病率比（PRs）和95%置信区间（CIs）计算CHD患病率。在匹配参保时长、参保开始时的年龄和年份后重复进行分析。在医疗补助样本中，我们还按人口统计学特征分层，并分别分析严重和非严重CHD诊断。多维度偏倚分析考虑了未测量的产前烟草暴露的影响。
在医疗补助样本的8732345名儿童中，患有FASD的儿童中有5.2%患有CHD，未患有FASD的儿童中有1.0%患有CHD（匹配队列PR = 3.4 [CI：2.8，4.1]）。按性别、种族和族裔分层以及仅查看严重或非严重CHD时，PRs相似。在商业索赔样本的10567765名儿童中，患有FASD的儿童中有3.0%患有CHD，未患有FASD的儿童中有0.6%患有CHD（匹配队列PR = 4.6 [CI：3.3，6.4]）。
在两个行政数据库样本中，与未患有FASD的儿童相比，患有FASD的儿童中CHD更为常见。提高医疗服务提供者对CHD作为潜在FASD合并症的认识可能会改善CHD的及时治疗。
