Ethnic disparities in congenital heart disease among infants in the UK and the underlying maternal risk factors

external supervisors

Clare Bankhead, Professor of Epidemiology and Research Design , Nuffield Department of Primary Care Health Sciences

Duncan Sparrow, Associate Professor and BHF Senior Basic Science Research Fellow, Department of Physiology, Anatomy and Genetics

background

Congenital heart disease (CHD) is the most common type of birth defect and is a leading cause of infant mortality globally. It is defined as structural abnormalities of the heart and/or the associated vasculature that are present at birth. In the UK about 13 affected babies are born each day. Around a third of the defects are due to genetic causes, but the remaining two-thirds may be due to environmental factors. Our recent study using data from the UK Clinical Practice Research Datalink (CPRD) including all pregnancies between 1998 and 2020 showed that pregnant women from ethnic minority backgrounds were more likely to give birth to babies with a structural heart defect compared with women from White ethnic backgrounds. The risk was three and a half times higher among Black women. A previous study (Knowles et al, 2017) showed a 50% higher incidence of CHD among infants from Black and Asian ethnicity compared with infants from White ethnic backgrounds in England and Wales. The aim of this project is to further investigate the ethnic disparities in CHD in the UK and their underlying maternal risk factors. The research objectives are to:

1. Examine the existing evidence related to ethnic disparities in CHD and its determinants in the UK and other high-income countries.
2. Investigate the maternal determinants underlying the ethnic disparities in offspring CHD using two separate CPRD datasets (GOLD and Aurum).
3. Use the findings from the above analyses to generate a risk prediction model. 

RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING

Training in advanced statistics, epidemiological methods, programming, and scientific writing will be provided. The student will gain hands-on training in handling and analysing large clinical datasets. Attendance at seminars, workshops and courses provided by both Oxford Population Health and Primary Care departments will also be encouraged. There will be opportunity to present research work at relevant international/national conferences.

PROSPECTIVE  STUDENT

This project will be most suitable for a student who has interest in epidemiology, statistics, population health, and ethnic inequalities in maternal and child health outcomes. Basic knowledge of epidemiology and statistics is required. Any experience of working with large datasets will be a bonus.