Social Drivers of Health, Management Bias, and Outcomes of Symptomatic Neonates With Tetralogy of Fallot.
Living over 100 miles from a cardiac center raises mortality hazard in neonates with symptomatic tetralogy of Fallot
Social Drivers of Health, Management Bias, and Outcomes of Symptomatic Neonates With Tetralogy of Fallot.
Advances in tetralogy of Fallot care have improved outcomes; however, sociodemographic disparities among infants with symptomatic tetralogy of Fallot requiring neonatal intervention (sTOF) remain incompletely characterized.
This study aimed to investigate sociodemographic and socioeconomic factors associated with management strategy and clinical outcomes in sTOF.
We conducted a retrospective cohort study of neonates with sTOF undergoing intervention between January 2005 and November 2017 at 9 centers in the Congenital Cardiac Research Collaborative.
living over 100 miles from a cardiac center more than doubles mortality risk
Among 417 neonates, 180 (43%) underwent primary repair and 237 (57%) staged repair.
Most were prenatally diagnosed (59%), non-Hispanic White (63%), and publicly insured (54%).
Maternal race-ethnicity and public insurance were associated with longer hospital stays and increased in-hospital complications.
Sociodemographic factors, including geography, race-ethnicity, insurance, and neighborhood opportunity, are associated with management and outcomes in neonates with sTOF.
Distance to care, maternal race-ethnicity, and insurance have notable impacts on these outcomes and warrant further assessment to ensure equitable decision-making management strategies.