{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:47:48Z","timestamp":1790704068868,"version":"4.1.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Poor interstage weight gain is a risk factor for adverse outcomes in infants with hypoplastic left heart syndrome. We sought to examine the association of neighborhood social vulnerability and interstage weight gain and determine if this association is modified by enrollment in our institution's Infant Single Ventricle Management and Monitoring Program (ISVMP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We performed a retrospective single\u2010center study of infants with hypoplastic left heart syndrome before (2007\u20132010) and after (2011\u20132020) introduction of the ISVMP. The primary outcome was interstage weight gain, and the secondary outcome was interstage growth failure. Multivariable linear and logistic regression models were used to examine the association between the Social Vulnerability Index and the outcomes. We introduced an interaction term into the models to test for effect modification by the ISVMP. We evaluated 217 ISVMP infants and 111 pre\u2010ISVMP historical controls. The Social Vulnerability Index was associated with interstage growth failure (\n                      <jats:italic>P<\/jats:italic>\n                      =0.001); however, enrollment in the ISVMP strongly attenuated this association (\n                      <jats:italic>P<\/jats:italic>\n                      =0.04). Pre\u2010ISVMP, as well as high\u2010 and middle\u2010vulnerability infants gained 4\u2009g\/d less and were significantly more likely to experience growth failure than low\u2010vulnerability infants (high versus low: adjusted odds ratio [aOR], 12.5 [95% CI, 2.5\u201362.2]; middle versus low: aOR, 7.8 [95% CI, 2.0\u201331.2]). After the introduction of the ISVMP, outcomes did not differ by Social Vulnerability Index tertile. Infants with middle and high Social Vulnerability Index scores who were enrolled in the ISVMP gained 4\u2009g\/d and 2\u2009g\/d more, respectively, than pre\u2010ISVMP controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In infants with hypoplastic left heart syndrome, high social vulnerability is a risk factor for poor interstage weight gain. However, enrollment in the ISVMP significantly reduces growth disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.030029","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T05:18:01Z","timestamp":1694582281000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2177-3032","authenticated-orcid":false,"given":"Rachel J.","family":"Shustak","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit The Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Tam","sequence":"additional","affiliation":[{"name":"Cartographic Modeling Lab University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson","family":"Stagg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-6330","authenticated-orcid":false,"given":"Therese M.","family":"Giglia","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chitra","family":"Ravishankar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-5942","authenticated-orcid":false,"given":"Laura","family":"Mercer\u2010Rosa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Guevara","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, The Children\u2019s Hospital of Philadelphia Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3656-3561","authenticated-orcid":false,"given":"Monique M.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Division of Cardiac Critical Care Medicine, The Children\u2019s Hospital of Philadelphia and Department of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania Philadelphia PA 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