{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:47:47Z","timestamp":1790704067210,"version":"4.1.0"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Low socioeconomic status (SES) has emerged as an important risk factor for higher short-term mortality and neurodevelopmental outcomes in children with hypoplastic left heart syndrome and related anomalies; yet little is known about how SES affects these outcomes over the long-term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We linked data from the Single Ventricle Reconstruction trial to US Census Bureau data to analyze the relationship of neighborhood SES tertiles with mortality and transplantation, neurodevelopment, quality of life, and functional status at 5 and 6 years post\u2013Norwood procedure (N = 525). Cox proportional hazards regression and linear regression were used to assess the association of SES with mortality and neurodevelopmental outcomes, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Patients in the lowest SES tertile were more likely to be racial minorities, older at stage 2 and Fontan procedures, and to have more complications and fewer cardiac catheterizations over follow-up (all P &amp;lt; .05) compared with patients in higher SES tertiles. Unadjusted mortality was highest for patients in the lowest SES tertile and lowest in the highest tertile (41% vs 29%, respectively; log-rank P = .027). Adjustment for patient birth and Norwood factors attenuated these differences slightly (P = .055). Patients in the lowest SES tertile reported lower functional status and lower fine motor, problem-solving, adaptive behavior, and communication skills at 6 years (all P &amp;lt; .05). These differences persisted after adjustment for baseline and post-Norwood factors. Quality of life did not differ by SES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among patients with hypoplastic left heart syndrome, those with low SES have worse neurodevelopmental and functional status outcomes at 6 years. These differences were not explained by other patient or clinical characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2020-1240","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T08:26:01Z","timestamp":1600935961000},"source":"Crossref","is-referenced-by-count":88,"title":["Socioeconomic Status and Long-term Outcomes in Single Ventricle Heart Disease"],"prefix":"10.1542","volume":"146","author":[{"given":"Emily M.","family":"Bucholz","sequence":"first","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Boston, Massachusetts;"},{"name":"Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn A.","family":"Sleeper","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Boston, Massachusetts;"},{"name":"Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caren S.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan and C.S. Mott Children\u2019s Hospital, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara K.","family":"Pasquali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan and C.S. Mott Children\u2019s Hospital, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children\u2019s Hospital, New York City, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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