Geospatial Distribution of Prenatally and Postnatally Diagnosed Congenital Heart Disease: Implications for Equitable Care from a Fetal Heart Society Research Collaborative Study

• Published in: The Journal of pediatrics 2024-10, Vol.273, p.114120, Article 114120
• Main Authors: Klein, Jennifer H., Cuneo, Bettina, Howley, Lisa, Kavanaugh-McHugh, Ann, Taylor, Carolyn, Chaves, Alicia H., Srivastava, Shubhika, Donofrio, Mary T., Gourishankar, Anand, Krishnan, Anita
• Format: Article
• Language: English
• Subjects: clusters; congenital heart disease; geospatial analysis; prenatal detection
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2024.114120

To characterize patterns in the geospatial distribution of pre- and postnatally diagnosed congenital heart disease (CHD) across 6 surgical centers. A retrospective, multicenter case series from the Fetal Heart Society identified patients at 6 centers from 2012 through 2016 with prenatally (PrND) or postnatally (PoND) diagnosed hypoplastic left heart syndrome (HLHS) or d-transposition of the great arteries (TGA). Geospatial analysis for clustering was done by the average nearest neighbor (ANN) tool or optimized hot spot tool, depending on spatial unit and data type. Both point location and county case rate per 10 000 live births were assessed for geographic clustering or dispersion. Of the 453 CHD cases, 26% were PoND (n = 117), and 74% were PrND (n = 336). PrND cases, in all but one center, displayed significant geographic clustering by the ANN. Conversely, PoND cases tended toward geographic dispersion. Dispersion of PoND HLHS occurred in 2 centers (ANN = 1.59, P