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Heart. 2012 Nov;98(22):1667-73. doi: 10.1136/heartjnl-2012-302543. Epub 2012 Aug 11.

Prevalence, timing of diagnosis and mortality of newborns with congenital heart defects: a population-based study.

Author information

1
Inserm, UMR S953, Recherche épidémiologique sur la santé périnatale et la santé des femmes et des enfants, UPMC, Université Paris-6, Maternité de Port-Royal, Paris, France. babak.khoshnood@inserm.fr

Abstract

OBJECTIVE:

To assess the prevalence, timing of diagnosis and infant mortality of congenital heart defects (CHD) with population-based data and using a classification that allows regrouping of the International Paediatric and Congenital Cardiac Code into a manageable number of categories based on anatomic and clinical criteria (ACC-CHD).

DESIGN:

Population-based cohort study.

SETTING:

Greater Paris.

PATIENTS:

All cases (live births, terminations of pregnancy for foetal anomaly (TOPFA), foetal deaths) diagnosed prenatally, or up to 1 year of age in the birth cohorts, May 2005-April 2008, for women in Greater Paris (n=317 538 births). Diagnoses were confirmed in specialised centres and subsequently coded and classified into the categories of ACC-CHD by paediatric cardiologists in the study group.

RESULTS:

The total number of CHD was 2867, including 2348 live births (82%), 466 TOPFA (16.2%) and 53 foetal deaths (1.8%). The total prevalence of CHD was 90 per 10 000. After exclusion of ventricular septal defects (VSD), 40% of 'isolated' CHD was diagnosed prenatally with about one half of the remaining diagnosed before 7 days of age. Nevertheless, one in five cases of these major CHD was diagnosed after the fourth week. Infant mortality of 'isolated' CHD-VSD excluded was 8.5% with 40% of deaths occurring after the fourth week of life. These outcomes varied substantially across categories of ACC-CHD.

CONCLUSIONS:

Timing of diagnosis, TOPFA, risk and timing of infant mortality were highly variable across the categories of CHD in ACC-CHD, suggesting that it may be a useful measure of severity, and hence, predictor of outcomes of CHD.

PMID:
22888161
DOI:
10.1136/heartjnl-2012-302543
[Indexed for MEDLINE]

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