Congenital heart diseaseCohort study
Social Drivers of Health, Management Bias, and Outcomes of Symptomatic Neonates With Tetralogy of Fallot
- retrospective cohort study
- 9 centers in the Congenital Cardiac Research Collaborative
Authors' conclusion
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.
Study context
- Population
- Neonates with symptomatic tetralogy of Fallot requiring neonatal intervention (sTOF) undergoing intervention between January 2005 and November 2017
- Participants
- 417 neonates
- Exposure
- Sociodemographic and socioeconomic factors (Childhood Opportunity Index; distance to cardiac center, maternal race-ethnicity, language, and insurance) associated with management strategy and clinical outcomes
- primary repairn = 180
- staged repairn = 237
- Outcome
- Management strategy: primary complete repair vs staged repair
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality · higher hazard for mortality with >100 miles | 2.38 (1.07–5.30) | P = 0.033 | |
| 0.20.5125Hazard ratio (log scale) |
Hospital stay and in-hospital complications
- Maternal race-ethnicity and public insurance were associated with longer hospital stays and increased in-hospital complications
Cohort characteristics
- prenatally diagnosed
- 59%
- non-Hispanic White
- 63%
- publicly insured
- 54%
Original publication
Social Drivers of Health, Management Bias, and Outcomes of Symptomatic Neonates With Tetralogy of Fallot. JACC Adv. Published 20 August 2026. doi:10.1016/j.jacadv.2026.103161
Summarised from the published abstract; every number is checked against it