Poster Session 4
Category: Epidemiology
Poster Session 4
Alexsaundra Zywicki, MD
University of Rochester Medical Center
Rochester, New York, United States
Zimeng Gao, MD, MS (she/her/hers)
Hackensack Meridian Health
Hackensack, New Jersey, United States
Sarah Crimmins, DO
University of Rochester Medical Center - - Roches
University of Rochester, New York, United States
Investigate the impact of maternal residency in regions with high Hazard Ranking System (HRS) scores on development of congenital heart disease (CHD). Of 786 the neonates born and diagnosed with CHD during the study dates, 462 met study inclusion, of which 27.5% (n = 127) resided in low HRS regions and 72.5% (n = 335) resided in high HRS regions. Demographic characteristics of the two cohorts were significantly different in maternal ethnicity, gestational age at delivery, and presence of extracardiac anomalies (Table 1). Adjusting against the background of all live births in each region, neonates with CHD and minimal antenatal risk factors had a higher risk of being born to an individual residing in a high risk HRS region (p = 0.03). There were significantly higher rates of critical CHD with maternal residency in high HRS regions, as well as higher rates of concurrent neonatal extracardiac anomalies and delivery at earlier gestational ages. Non-Hispanic Black and Hispanic patients reside in high HRS areas at disproportionate rates when compared to other demographic groups. Continued characterization of the potential reproductive and developmental consequences from maternal exposures to environmental toxicities at a regional level is necessary to optimize pregnancy outcomes for the maternal-fetal dyad.
Study Design:
Retrospective cohort study of neonates with CHD who delivered between 1/1/2016 and 1/1/2024 at Strong Memorial Hospital in Rochester, New York. Antepartum environmental toxin exposure was estimated utilizing the HRS score assigned to the residential zip code at time of delivery. High HRS regions were defined as those listed on the National Priorities List and low HRS regions were those that were not. Inclusion criteria included neonates with confirmed CHD by neonatal echocardiogram or autopsy. Exclusion included age < 18 years, poorly control maternal diabetes (prepregnancy Hgb A1C ≥ 7%), family history of CHD, conception by IVF, or maternal teratogenic exposure. Chi-square tests were performed to compare rates of critical CHD by HRS risk category.
Results:
Conclusion: