Table 2:
Associations of infant, care-related and sociodemographic factors with distance from home to birth hospital and transfer status for repair, among all infants with hypoplastic left heart syndrome (including those who died within the first 7 days of life), California, 2006–2011.
| Lived Close/Not Transferred† (n=117) | Lived Close/Transferred† (n=187) | |||
|---|---|---|---|---|
| Unadjusted risk ratio (95% CI) | Adjusted risk ratio (95% CI)‡ | Unadjusted risk ratio (95% CI) | Adjusted risk ratio (95% CI)‡ | |
| Infant and care-related factors | ||||
| Sex | ||||
| Male | 0.86 (0.64–1.16) | 0.70 (0.51–0.95) | 1.10 (0.87–1.38) | 1.01 (0.87–1.16) |
| Female | Ref | Ref | Ref | Ref |
| Birth weight (g) | ||||
| <2500 | 1.29 (0.94–1.76) | 1.25 (0.88–1.78) | 0.87 (0.65–1.16) | 0.96 (0.81–1.13) |
| ≥2500 | Ref | Ref | Ref | Ref |
| Gestational age (wk) | ||||
| <37 | 1.06 (0.73–1.55) | 1.00 (0.67–1.49) | 1.06 (0.81–1.38) | 1.01 (0.81–1.26) |
| ≥37 | Ref | Ref | Ref | Ref |
| 5-Minute APGAR score | ||||
| <7 | 1.57 (1.13–2.17) | 1.48 (1.04–2.10) | 0.74 (0.49–1.12) | 0.88 (0.70–1.11) |
| ≥7 | Ref | Ref | Ref | Ref |
| Co-occurring major birth defects | ||||
| None | Ref | Ref | Ref | Ref |
| Any | 1.78 (1.19–2.65) | 1.46 (0.94–2.27) | 1.17 (0.76–1.81) | 1.12 (0.75–1.67) |
| Prenatal care initiation | ||||
| Trimester 1 | 0.73 (0.51–1.05) | 0.78 (0.54–1.11) | 0.91 (0.68–1.23) | 0.98 (0.77–1.26) |
| Trimester 2, later or none/unknown | Ref | Ref | Ref | Ref |
| Level of care of birth hospital | ||||
| Level I/II | Ref | Ref | Ref | Ref |
| Level III | 0.62 (0.46–0.83) | 0.77 (0.51–1.16) | 0.63 (0.54–0.73) | 0.94 (0.84–1.05) |
| Level IV | 0.22 (0.15–0.34) | 0.41 (0.27–0.64) | 0.07 (0.03–0.12) | 0.62 (0.53–0.72) |
| Sociodemographic factors | ||||
| Age (yrs) | ||||
| <20 | 1.11 (0.62–1.99) | 1.83 (0.97–3.48) | 1.31 (0.95–1.80) | 1.19 (0.94–1.49) |
| 20–34 | Ref | Ref | Ref | Ref |
| ≥35 | 0.86 (0.59–1.27) | 0.80 (0.53–1.19) | 0.78 (0.57–1.06) | 0.93 (0.77–1.11) |
| Race/ethnicity | ||||
| White Non-Hispanic | Ref | Ref | Ref | Ref |
| Hispanic – US born | 1.29 (0.77–2.16) | 1.12 (0.64–1.95) | 1.21 (0.89–1.65) | 0.99 (0.81–1.21) |
| Hispanic – Foreign born | 1.54 (1.01–2.36) | 1.56 (0.92–2.65) | 1.04 (0.77–1.39) | 0.92 (0.75–1.12) |
| Black Non-Hispanic | 2.20 (1.22–3.94) | 1.82 (0.98–3.39) | 1.69 (1.19–2.42) | 1.10 (0.85–1.43) |
| Asian/Pacific Islander | 2.36 (1.27–4.39) | 2.12 (0.94–4.82) | 1.77 (1.22–2.58) | 1.26 (0.93–1.71) |
| Other | 1.92 (0.99–3.72) | 1.46 (0.82–2.61) | 1.14 (0.62–2.06) | 1.02 (0.72–1.45) |
| Education | ||||
| Less than high school | 1.24 (0.82–1.87) | 0.99 (0.67–1.47) | 1.11 (0.85–1.44) | 1.04 (0.88–1.22) |
| High school graduate | Ref | Ref | Ref | Ref |
| Some college or higher | 1.22 (0.81–1.82) | 1.65 (1.07–2.55) | 1.02 (0.78–1.34) | 1.06 (0.88–1.27) |
| Medical Insurance | ||||
| Private | Ref | Ref | Ref | Ref |
| Medi-Cal/Other Governmental | 1.20 (0.87–1.64) | 1.01 (0.67–1.53) | 1.20 (0.95–1.52) | 1.05 (0.88–1.24) |
| Census tract poverty level | ||||
| <25 percentile | 0.76 (0.47–1.23) | 0.62 (0.35–1.09) | 0.75 (0.53–1.06) | 0.89 (0.73–1.08) |
| 25–75 percentile | Ref | Ref | Ref | Ref |
| >75 percentile | 1.96 (1.45–2.65) | 1.94 (1.41–2.68) | 1.54 (1.24–1.91) | 1.21 (1.05–1.40) |
†
Lived close was defined as <11 miles from home to the birth hospital and lived far as ≥11miles, based on the median. The Reference Group was 248 infants who lived far and were not transferred.
‡
Each risk ratio was adjusted only for the sociodemographic factors (age, race/ethnicity, education, insurance, and neighborhood poverty)
CI = confidence interval