Abstract P296: The Association Between Maternal Occupation and Adverse Birth Outcomes Among Infants With Congenital Heart Defects

Background: Neonates with critical congenital heart defects (cCHDs) face increased risks of neonatal complications, including low birth weight (LBW) and preterm birth (PTB). Maternal occupation has known associations with adverse birth outcomes in the general population. We aimed to assess the link between maternal occupation and adverse birth outcomes in neonates with cCHDs. Methods: We examined Texas Birth Defects Registry (TBDR) data from 1999-2014, focusing on employed mothers of non-syndromic live born singletons with cCHD. Using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS) and manual coding, we categorized maternal occupation into 23 major groups. Neonates with cCHDs and adverse birth outcomes were compared to neonates with cCHDs without adverse outcomes. Logistic regression models assessed the association between maternal occupation and PTB and LBW, with the reference group being all other occupations. Results: There were 712 mothers with preterm neonates with cCHDs and 3,076 mothers with full-term neonates with cCHDs. Additionally, 776 mothers delivered LBW neonates, while 3,012 had normal birthweight neonates. Maternal occupations in computer/math science were negatively linked to PTB (OR: 0.29; 95% CI: 0.10-0.79) and LBW (OR: 0.26; 95% CI: 0.09-0.70). Food preparation occupations were positively associated with PTB (OR: 1.67; 95% CI: 1.17-2.38), while arts/entertainment occupations were negatively associated with LBW (OR: 0.30; 95% CI: 0.11-0.84). Conclusion: These findings align with previous reports, suggesting that mothers in certain occupations may engage in behaviors linked to adverse pregnancy outcomes in the general population, such as insufficient folic acid supplementation, delayed prenatal care, smoking, and drinking. Understanding these associations can inform targeted workplace interventions, particularly for pregnancies involving birth defects.