Maternal immigrant status increased mortality risk in children with congenital heart disease, with adjusted HRs of 1.17 (95% CI 1.06-1.30) for nonrefugee immigrants and 1.33 for refugees.
Cohort
Yes
Does maternal immigrant status affect mortality in children with congenital heart disease?
Children with congenital heart disease born to immigrant and refugee mothers have a significantly higher risk of mortality compared to those born to nonimmigrant mothers, highlighting health inequities.
Hazard Ratio: 1.17 (95% CI 1.06–1.3)
BACKGROUND: This study examined the association between maternal immigrant status and survival of children with congenital heart diseases (CHD) in Ontario, Canada. METHODS: A retrospective population-based cohort study of hospital live births between April 2002 to September 2020 in Ontario, Canada was conducted at the Institute for Clinical Evaluative Sciences. Multilevel Cox hazard regression models generated hazard ratios (HR) for the association between maternal immigrant status and child death while accounting for hospitals as a cluster factor and adjusting for maternal age at birth, neighborhood income and education quintiles, comorbidities, a composite of severe maternal morbidity, gestational age at birth, birth weight, infant sex and residential rurality among all CHD, severe CHD or single ventricle patients. RESULTS: Among children with any CHD, relative to children born to nonimmigrants, the adjusted HR was 1.17 (95% CI: 1.06-1.30) in children born to nonrefugee immigrants, and 1.33 (95% CI: 1.07-1.65) in those born to refugees. Similar patterns were observed in children with severe CHD, particularly within the single ventricle CHD subcohort, where the adjusted HR for children born to refugees was 2.01 (95% CI: 1.5-2.7) relative to those born to nonimmigrants. CONCLUSION: Health policy decision-makers should prioritize understanding the underlying causes of mortality in these populations to reduce health inequities.
Miao et al. (Sat,) ont réalisé une étude de cohorte sur les maladies cardiaques congénitales (MCC). Le statut d'immigrant maternel par rapport au statut de non-immigrant maternel a été évalué sur la mortalité infantile (HR 1.17, IC 95 % 1.06-1.30). Le statut d'immigrant maternel a augmenté le risque de mortalité chez les enfants atteints de maladies cardiaques congénitales, avec des HR ajustés de 1.17 (IC 95 % 1.06-1.30) pour les immigrants non réfugiés et 1.33 pour les réfugiés.