Table 1.
Characteristics of the study population
| All deliveries | Deliveries with CHD diagnosis | ||||
|---|---|---|---|---|---|
| Maternal congenital heart disease | ≥1 cardiac comorbidity diagnosis | ||||
| Absent, n (%) | Present, n (%) | Absolute SMD | Absent, n (%) | Present, n (%) | |
| Demographics | |||||
| Year of delivery | |||||
| 2000 | 3,813,256 (5.2%) | 1,593 (3.1%) | 1,346 (3.3%) | 247 (2.3%) | |
| 2001 | 3,748,220 (5.1%) | 1,573 (3.0%) | 1,327 (3.2%) | 246 (2.3%) | |
| 2002 | 3,901,478 (5.3%) | 1,927 (3.7%) | 1,645 (4.0%) | 282 (2.7%) | |
| 2003 | 3,860,150 (5.3%) | 1,912 (3.7%) | 1,616 (3.9%) | 296 (2.8%) | |
| 2004 | 3,996,680 (5.5%) | 2,318 (4.5%) | 1,967 (4.8%) | 352 (3.3%) | |
| 2005 | 4,006,839 (5.5%) | 2,501 (4.8%) | 2,097 (5.1%) | 404 (3.8%) | |
| 2006 | 4,058,003 (5.6%) | 2,500 (4.8%) | 2,042 (5.0%) | 458 (4.3%) | |
| 2007 | 4,325,907 (5.9%) | 2,633 (5.1%) | 2,122 (5.1%) | 511 (4.8%) | |
| 2008 | 4,009,089 (5.5%) | 2,950 (5.7%) | 2,358 (5.7%) | 593 (5.6%) | |
| 2009 | 3,914,417 (5.4%) | 2,649 (5.1%) | 2,073 (5.0%) | 576 (5.5%) | |
| 2010 | 3,682,270 (5.0%) | 2,882 (5.6%) | 2,297 (5.6%) | 585 (5.5%) | |
| 2011 | 3,644,493 (5.0%) | 2,698 (5.2%) | 2,066 (5.0%) | 632 (6.0%) | |
| 2012 | 3,746,736 (5.1%) | 2,940 (5.7%) | 2,230 (5.4%) | 710 (6.7%) | |
| 2013 | 3,724,883 (5.1%) | 3,140 (6.1%) | 2,385 (5.8%) | 755 (7.1%) | |
| 2014 | 3,781,085 (5.2%) | 3,340 (6.4%) | 2,635 (6.4%) | 705 (6.7%) | |
| 2015 | 3,734,835 (5.1%) | 3,230 (6.2%) | 2,575 (6.2%) | 655 (6.2%) | |
| 2016 | 3,778,856 (5.2%) | 3,630 (7.0%) | 2,855 (6.9%) | 775 (7.3%) | |
| 2017 | 3,699,356 (5.1%) | 3,475 (6.7%) | 2,645 (6.4%) | 830 (7.9%) | |
| 2018 | 3,631,394 (5.0%) | 3,950 (7.6%) | 2,990 (7.2%) | 960 (9.1%) | |
| Maternal race | 24.4% | ||||
| Non-Hispanic White | 32,127,323 (44.0%) | 29,222 (56.4%) | 23,415 (56.7%) | 5,807 (54.9%) | |
| Non-Hispanic Black | 8,393,454 (11.5%) | 4,418 (8.5%) | 3,359 (8.1%) | 1,059 (10.0%) | |
| Hispanic | 13,814,858 (18.9%) | 7,179 (13.9%) | 5,582 (13.5%) | 1,597 (15.1%) | |
| Other | 6,588,541 (9.0%) | 3,536 (6.8%) | 2,803 (6.8%) | 733 (6.9%) | |
| Unknown | 12,133,771 (16.6%) | 7,487 (14.4%) | 6,111 (14.8%) | 1,375 (13.0%) | |
| Maternal age | 6.6% | ||||
| 15–19 years old | 17,053,860 (23.3%) | 11,677 (22.5%) | 23,415 (56.7%) | 5,807 (54.9%) | |
| 20–29 years old | 20,386,510 (27.9%) | 14,518 (28.0%) | 3,359 (8.1%) | 1,059 (10.0%) | |
| 30–34 years old | 18,259,847 (25.0%) | 13,250 (25.6%) | 5,582 (13.5%) | 1,597 (15.1%) | |
| 35–39 years old | 8,961,164 (12.3%) | 6,143 (11.9%) | 2,803 (6.8%) | 733 (6.9%) | |
| 40–54 years old | 2,042,006 (2.8%) | 1,485 (2.9%) | 6,111 (14.8%) | 1,375 (13.0%) | |
| Payer | 12.1% | ||||
| Medicare | 422,482 (0.6%) | 792 (1.5%) | 507 (1.2%) | 285 (2.7%) | |
| Medicaid | 30,156,706 (41.3%) | 19,616 (37.8%) | 15,445 (37.4%) | 4,171 (39.5%) | |
| Private Insurance | 38,069,895 (52.1%) | 28,737 (55.4%) | 23,228 (56.3%) | 5,509 (52.1%) | |
| Self-pay | 2,238,596 (3.1%) | 958 (1.9%) | 735 (1.8%) | 222 (2.1%) | |
| No Charge | 134,249 (0.2%) | 47 (0.1%) | 28 (0.1%) | 19 (0.2%) | |
| Other | 1,914,651 (2.6%) | 1,601 (3.1%) | 1,251 (3.0%) | 350 (3.3%) | |
| Unknown | 121,369 (0.2%) | 90 (.2%) | 76 (0.2%) | 14 (0.1%) | |
| ZIP code income quartile | 10.2% | ||||
| Income Quartile 1 | 17,350,802 (23.8%) | 11,616 (22.4%) | 9,003 (21.8%) | 2,613 (24.7%) | |
| Income Quartile 2 | 17,672,246 (24.2%) | 12,263 (23.7%) | 9,729 (23.6%) | 2,535 (24.0%) | |
| Income Quartile 3 | 17,788,278 (24.4%) | 13,241 (25.5%) | 10,707 (25.9%) | 2,534 (24.0%) | |
| Income Quartile 4 | 19,094,137 (26.1%) | 13,968 (26.9%) | 11,226 (27.2%) | 2,743 (26.0%) | |
| Unknown | 1,152,484 (1.6%) | 752 (1.5%) | 606 (1.5%) | 146 (1.4%) | |
| Obstetric and medical factors | |||||
| Obesity | 3,004,877 (4.1%) | 3,119 (6.0%) | 8.7% | 2,342 (5.7%) | 778 (7.4%) |
| Pre-gestational diabetes | 663,626 (0.9%) | 736 (1.4%) | 4.8% | 607 (1.5%) | 129 (1.2%) |
| Chronic hypertension | 1,006,571 (1.4%) | 1,938 (3.7%) | 15.0% | 1,259 (3.1%) | 678 (6.4%) |
| Multiple gestation | 1,312,925 (1.8%) | 1,102 (2.1%) | 2.4% | 849 (2.1%) | 254 (2.4%) |
| Hospital factors | |||||
| Hospital location | 30.6% | ||||
| Rural | 8,147,291 (11.2%) | 3,901 (7.5%) | 3,346 (8.1%) | 555 (5.3%) | |
| Urban non-teaching | 27,460,828 (37.6%) | 12,779 (24.7%) | 10,682 (25.9%) | 2,097 (19.8%) | |
| Urban teaching | 37,222,564 (51.0%) | 34,995 (67.5%) | 27,105 (65.7%) | 7,890 (74.6%) | |
| Missing | 227,264 (0.3%) | 167 (0.3%) | 138 (0.3%) | 29 (0.3%) | |
| Region | 14.7% | ||||
| Northeast | 11,858,021 (16.2%) | 10,402 (20.1%) | 8,506 (20.6%) | 1,897 (17.9%) | |
| Midwest | 15,549,763 (21.3%) | 12,270 (23.7%) | 9,644 (23.4%) | 2,626 (24.8%) | |
| South | 27,647,616 (37.8%) | 17,023 (32.8%) | 13,493 (32.7%) | 3,529 (33.4%) | |
| West | 18,002,548 (24.6%) | 12,147 (23.4%) | 9,627 (23.3%) | 2,520 (23.8%) | |
SMD, standardized mean difference. CHD, congenital heart disease. Additional diagnoses representative of cardiac comorbidity: congestive heart failure, arrhythmia, valvular disease, pulmonary disorders, and history of thromboembolism.