Skip to main content

Advertisement

SpringerLink
Log in

Changing Prevalence of Severe Congenital Heart Disease: A Population-Based Study

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Although the epidemiology of congenital heart disease (CHD) has been described, the authors believe changes in prenatal factors such as termination of pregnancy for fetal anomaly and prenatal vitamin supplementation have altered the birth prevalence of severe CHD. This population-based study reviewed the Nationwide Inpatient Sample (NIS) database and identified all cases with a severe CHD diagnosis among all live birth entries from 1999 to 2008. A time trend analysis then was performed for specific severe CHD diagnoses stratified by race, socioeconomic status, and geographic location. Overall, severe CHD prevalence was 147.4 per 100,000 live births, with a temporal decrease in prevalence from 168.9 per 100,000 in 1999 to 129.3 per 100,000 in 2008 (p = 0.03). Among the 12 severe CHD diagnoses included in our cohort, the prevalence of truncus arteriosus (p = 0.02), tetralogy of Fallot (p = 0.001), hypoplastic left heart syndrome (p = 0.001), and pulmonary atresia (p = 0.01) decreased significantly during the study period. The observed prevalence trends varied significantly by race (Caucasians), socioeconomic class (upper income quartiles), and geographic location (Northeast and West regions). The study findings showed a temporal decrease in severe CHD prevalence, which varied by race, socioeconomic status, and geographic location. The authors speculated that the observed trend might be due to increased termination of fetuses with prenatally diagnosed CHD. The impact of sociodemographic variables on the observed prevalence trend might be due to differences in access to specialized perinatal care and fetal heart programs or because of variability in termination of pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bjornard K, Riehle-Colarusso T, Gilboa SM, Correa A (2013) Patterns in the prevalence of congenital heart defects, metropolitan Atlanta, 1978 to 2005: birth defects research: Part A. Clin Mol Teratol 97:87–94

    Article  CAS  Google Scholar 

  2. Botto LD, Correa A, Erickson JD (2001) Racial and temporal variations in the prevalence of heart defects. Pediatrics 107:U18–U25

    Article  Google Scholar 

  3. Bull C, Assoc BPC (1999) Current and potential impact of fetal diagnosis on prevalence and spectrum of serious congenital heart disease at term in the Uk. Lancet 354:1242–1247

    Article  CAS  PubMed  Google Scholar 

  4. Dickinson DF, Arnold R, Wilkinson JL (1981) Congenital heart disease among 160,480 liveborn children in Liverpool 1960 to 1969: implications for surgical treatment. BMJ 46:55–62

    CAS  Google Scholar 

  5. Dilber D, Malcic I (2010) Spectrum of congenital heart defects in Croatia. Eur J Pediatr 169:543–550

    Article  PubMed  Google Scholar 

  6. Ferencz C, Rubin JD, McCarter RJ, Brenner JI, Neill CA, Perry LW, Hepner SI, Downing JW (1985) Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study. Am J epidemiol 121:31–36

    CAS  PubMed  Google Scholar 

  7. Fixler DE, Pastor P, Chamberlin M, Sigman E, Eifler CW (1990) Trends in congenital heart disease in Dallas County births, 1971–1984. Circulation 81:137–142

    Article  CAS  PubMed  Google Scholar 

  8. Grabitz RG, Joffres MR, Collins-Nakai RL (1988) Congenital heart disease: incidence in the first year of life. The Alberta Heritage Pediatric Cardiology Program. Am J Epidemiol 128:381–388

    CAS  PubMed  Google Scholar 

  9. HCUP Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUP), 1998–2008. Agency for Healthcare Research and Quality. Retrieved 22 October 2013 at http://www.hcup-us.ahrq.gov/nisoverview.jsp

  10. Hoffman JI, Christianson R (1978) Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol 42:641–647

    Article  CAS  PubMed  Google Scholar 

  11. Hoffman JI, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39:1890–1900

    Article  PubMed  Google Scholar 

  12. Ionescu-Ittu R, Marelli AJ, Mackie AS, Pilote L (2009) Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada. BMJ 338:b1673

    Article  PubMed Central  PubMed  Google Scholar 

  13. Khoshnood B, De Vigan C, Vodovar V, Goujard J, Lhomme A, Bonnet D, Goffinet F (2005) Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in france, 1983–2000: a population-based evaluation. Pediatrics 115:95–101

    PubMed  Google Scholar 

  14. Khoshnood B, Lelong N, Houyel L, Thieulin AC, Jouannic JM, Magnier S, Delezoide AL, Magny JF, Rambaud C, Bonnet D, Goffinet F, Group ES (2012) Prevalence, timing of diagnosis, and mortality of newborns with congenital heart defects: a population-based study. Heart 98:1667–1673

    Article  PubMed  Google Scholar 

  15. Khoshnood B, Loane M, Garne E, Addor MC, Arriola L, Bakker M, Barisic I, Bianca S, Boyd P, Calzolari E, Doray B, Draper E, Gatt M, Haeusler M, Melve KK, Latos-Bielenska A, McDonnell B, Mullaney C, Nelen V, O’Mahony M, Pierini A, Queisser-Luft A, Randrianaivo H, Rankin J, Rissmann A, Salvador J, Tucker D, Verellen-Dumoulin C, Wellesley D, Zymak-Zakutnya N, Dolk H (2013) Recent decrease in the prevalence of congenital heart defects in Europe. J Pediatr 162(108–113):e102

    Google Scholar 

  16. Lee K, Khoshnood B, Chen L, Wall SN, Cromie WJ, Mittendorf RL (2001) Infant mortality from congenital malformations in the United States, 1970–1997. Obstet Gynecol 98:620–627

    Article  CAS  PubMed  Google Scholar 

  17. Lee JE, Jung KL, Kim SE, Nam SH, Choi SJ, Oh SY, Roh CR, Kim JH (2010) Prenatal diagnosis of congenital heart disease: trends in pregnancy termination rate and perinatal and 1-year infant mortalities in Korea between 1994 and 2005. J Obstet Gynecol Res 36:474–478

    Article  Google Scholar 

  18. Lindinger A, Schwedler G, Hense HW (2010) Prevalence of congenital heart defects in newborns in Germany: results of the first registration year of the pan study (July 2006 to June 2007). Klin Padiatr 222:321–326

    Article  CAS  PubMed  Google Scholar 

  19. McAuliffe FM, Trines J, Nield LE, Chitayat D, Jaeggi E, Hornberger LK (2005) Early fetal echocardiography: a reliable prenatal diagnosis tool. Am J Obstet Gynecol 193:1253–1259

    Article  PubMed  Google Scholar 

  20. Mitchell SC, Korones SB, Berendes HW (1971) Congenital heart disease in 56,109 births incidence and natural history. Circulation 43:323–332

    Article  CAS  PubMed  Google Scholar 

  21. Montana E, Khoury MJ, Cragan JD, Sharma S, Dhar P, Fyfe D (1996) Trends and outcomes after prenatal diagnosis of congenital cardiac malformations by fetal echocardiography in a well-defined birth population, Atlanta, Georgia, 1990–1994. J Am Coll Cardiol 28:1805–1809

    Article  CAS  PubMed  Google Scholar 

  22. Moons P, Sluysmans T, De Wolf D, Massin M, Suys B, Benatar A, Gewillig M (2009) Congenital heart disease in 111,225 births in Belgium: birth prevalence, treatment, and survival in the 21st century. Acta Paediatr 98:472–477

    Article  PubMed  Google Scholar 

  23. Nationwide Inpatient Sample (NIS) Trends Supplemental Files, 1998–2008. Retrieved 28 September 2013 at http://www.hcup-us.ahrq.gov/db/nation/nis/nistrends.jsp

  24. Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A (2008) Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr 153:807–813

    Article  PubMed Central  PubMed  Google Scholar 

  25. Tennstedt C, Chaoui R, Korner H, Dietel M (1999) Spectrum of congenital heart defects and extracardiac malformations associated with chromosomal abnormalities: results of a seven-year necropsy study. Heart 82:34–39

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, Roos-Hesselink JW (2011) Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 58:2241–2247

    Article  PubMed  Google Scholar 

  27. Wren C, Richmond S, Donaldson L (2000) Temporal variability in birth prevalence of cardiovascular malformations. Heart 83:414–419

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We acknowledge the Nationwide Inpatient Sample (NIS), the Healthcare Cost and Utilization Project (HCUP), and the Agency for Healthcare Research and Quality for granting us unlimited access to their database. We also thank Jen Yau, John Doucette, and Ugochi Egbe for their contribution during data mining, formatting, statistical analysis, and proofreading.

Conflict of interest

There are no relevant financial interests, affiliations, or potential conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Pediatric Cardiology, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1201, New York, NY, 10029, USA

    Alexander Egbe, Santosh Uppu, Simon Lee & Shubhika Srivastava

  2. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Deborah Ho

Authors
  1. Alexander Egbe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Santosh Uppu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deborah Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shubhika Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexander Egbe.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Egbe, A., Uppu, S., Lee, S. et al. Changing Prevalence of Severe Congenital Heart Disease: A Population-Based Study. Pediatr Cardiol 35, 1232–1238 (2014). https://doi.org/10.1007/s00246-014-0921-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-014-0921-7

Keywords

Search

Navigation