Abstract
Background
Congenital heart diseases (CHD) are the most common birth defect. Previous studies found sex disparities in outcomes after cardiac surgery and in access to treatment, but little data is available for low- and middle-income countries (LMIC).
Methods
Data on CHD surgical admissions in children
Findings
Of 108,439 surgical admissions, 54.4% (59,021/108,439) were males. After adjusting for case mix, no statistically significant differences in odds ratios for mortality or infection by sex were found, although females had a lower risk of death in lower complexity and higher risk of infection in higher complexity surgeries. Six lesions analysis revealed higher odds of mortality in females for ventricular septal defect repair and higher risk of major infection for coarctation repair and the arterial switch operation compared with males. For 5 of the 6 lesions, fewer females underwent surgery in IQIC compared with the United States.
Interpretation
Our findings suggest that female children in LMIC have unequal access to CHD surgery compared with males with few postoperative differences in mortality or infection. Cultural and socio-economic factors such as access to timely diagnosis may be contributory.