Study: Risk of death from congenital heart disease varies geographically in U.S.

African-American baby receives heart check from clinician using stethoscope.

The likelihood an infant will die from congenital heart disease depends on where they live in the United States, according to a study published in The Lancet Child & Adolescent Health. Congenital heart disease involves defects in the heart’s structure that are present at birth and represents the most common type of birth defect.

In the study, researchers analyzed data from nearly 14,000 U.S. infants who died from congenital heart disease. They found that children with the condition in Kentucky and Mississippi had the greatest risk while three New England states—Connecticut, Massachusetts, and Rhode Island—had the lowest risk.

"The main take-home message is that social determinants of health impact outcome for infants with congenital heart disease," said study coauthor Jonathan Kaltman, Ph.D., senior scientific advisor for data science in the NHLBI’s Division of Cardiovascular Sciences.

"Specifically, we showed that infants of mothers that lived in areas with higher poverty or areas that were farther from top-performing cardiac centers had worse infant mortality due to congenital heart disease," Kaltman said in an email.

Congenital heart disease occurs in 1% of livebirths per year in the U.S., with about 25% of these infants requiring surgery or invasive procedures during the first year of life, Kaltman and his team noted.

The researcher pointed out that the health disparities can be remedied. "First, we need to determine which infants are at highest risk for poor outcomes," Kaltman added. "This study shows that those risk factors are not just medical, but they are also socioeconomic and demographic. Then, we need to target interventions to these high-risk groups. Further study is needed to determine what the most appropriate interventions might be, but they could possibly include home nursing visits, family education, and/or frequent telemedicine check-ins."

The study was conducted by researchers at the NHLBI. In addition to Kaltman, NHLBI co-authors of this study include Michelle Udine, M.D., Frank Evans, Ph.D., and Gail Pearson, M.D.