Title: Temporal Variation of Birth Prevalence of Congenital Heart Disease in the United States
Abstract: Congenital Heart DiseaseVolume 10, Issue 1 p. 43-50 ORIGINAL ARTICLE Temporal Variation of Birth Prevalence of Congenital Heart Disease in the United States Alexander Egbe MD, MPH, Corresponding Author Alexander Egbe MD, MPH Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USACorresponding Author: Alexander Egbe, MD, MPH, Division of Pediatric Cardiology, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1201, New York, NY 10029, USA. Tel: 212-241-5883; Fax: 18887192864; E-mail: [email protected]Search for more papers by this authorSantosh Uppu MD, Santosh Uppu MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorSimon Lee MD, Simon Lee MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorAnnemarie Stroustrup MD, MPH, Annemarie Stroustrup MD, MPH Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USA Department of Preventative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USASearch for more papers by this authorDeborah Ho MD, Deborah Ho MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorShubhika Srivastava MBBS, Shubhika Srivastava MBBS Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this author Alexander Egbe MD, MPH, Corresponding Author Alexander Egbe MD, MPH Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USACorresponding Author: Alexander Egbe, MD, MPH, Division of Pediatric Cardiology, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1201, New York, NY 10029, USA. Tel: 212-241-5883; Fax: 18887192864; E-mail: [email protected]Search for more papers by this authorSantosh Uppu MD, Santosh Uppu MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorSimon Lee MD, Simon Lee MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorAnnemarie Stroustrup MD, MPH, Annemarie Stroustrup MD, MPH Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USA Department of Preventative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USASearch for more papers by this authorDeborah Ho MD, Deborah Ho MD Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this authorShubhika Srivastava MBBS, Shubhika Srivastava MBBS Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, NY, USASearch for more papers by this author First published: 24 February 2014 https://doi.org/10.1111/chd.12176Citations: 32Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Background This is a longitudinal analysis of the largest and most comprehensive inpatient care database in the United States to determine temporal variation of birth prevalence of congenital heart disease (CHD) diagnosis, adjusting for potentially confounding factors. Methods We compared all entries of CHD diagnoses in the Nationwide Inpatient Sample (NIS) database in 1998 and 2008 to determine differences in birth prevalence of overall CHD and specific CHD phenotypes stratified by race, gender, socioeconomic status, and geographical location. Results CHD prevalence was 10.2/1000 in 1998 and 10.8/1000 live births in 2008, without significant changes in prevalence (P = .09). Prevalence of isolated patent ductus arteriosus increased from 1.9 to 2.8 per 1000 (P < .001), and this temporal increase remained statistically significant after stratification by race, income status, and geographic location. Prevalence of mild CHD increased from 8.0 to 9.1 per 1000 (P = .01), with most of this increase occurring among Caucasians and the upper socioeconomic class. There was a decrease in prevalence of severe CHD from 1.5 to 0.9 (P = .03), while prevalence of moderate CHD and all other specific CHD phenotypes remained unchanged in both cohorts. Conclusions We report increased prevalence of isolated patent ductus arteriosus and mild CHD; decreased prevalence of severe CHD; and unchanged prevalence of overall CHD and all other specific CHD phenotype. We speculate that increased prevalence of mild CHD was due to increased case detection because of improvement in echocardiography. Decrease in diagnosis of severe CHD could be due to the impact of pregnancy termination. Supporting Information Filename Description chd12176-sup-0001-si.docx12.6 KB Table S1. CHD classification based on severity. Table S2. CHD classification based on anatomic location. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. References 1 Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births incidence and natural history. Circulation. 1971; 43: 323–332. 2 Hoffman JI, Christianson R. Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol. 1978; 42: 641–647. 3 Laursen HB. Some epidemiological aspects of congenital heart-disease in Denmark. Acta Paediatr Scand. 1980; 69: 619–624. 4 Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2010; 13: 26–34. 5 Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002; 39: 1890–1900. 6 Wren C, Richmond S, Donaldson L. Temporal variability in birth prevalence of cardiovascular malformations. Heart. 2000; 83: 414–419. 7 Botto LD, Correa A, Erickson JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics. 2001; 107: U18–U25. 8 Ferencz C, Rubin JD, McCarter RJ, et al. Congenital heart disease: prevalence at livebirth. The Baltimore-Washington infant study. Am J Epidemiol. 1985; 121: 31–36. 9 Parker SE, Mai CT, Canfield MA, et al.; National Birth Defects Prevention Network. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004–2006. Birth Defects Res A Clin Mol Teratol. 2010; 88: 1008–1016. 10 Lee K, Khoshnood B, Chen L, Wall SN, Cromie WJ, Mittendorf RL. Infant mortality from congenital malformations in the United States, 1970–1997. Obstet Gynecol. 2001; 98: 620–627. 11 Fixler DE, Pastor P, Chamberlin M, Sigman E, Eifler CW. Trends in congenital heart disease in Dallas county births. 1971–1984. Circulation. 1990; 81: 137–142. 12 Bjornard K, Riehle-Colarusso T, Gilboa SM, Correa A. Patterns in the prevalence of congenital heart defects, Metropolitan Atlanta, 1978 to 2005. Birth Defects Res A Clin Mol Teratol. 2013; 97: 87–94. 13 Khoshnood B, De Vigan C, Vodovar V, et al. Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in france, 1983–2000: a population-based evaluation. Pediatrics. 2005; 115: 95–101. 14 Montana E, Khoury MJ, Cragan JD, Sharma S, Dhar P, Fyfe D. 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. 1996; 28: 1805–1809. 15 Lee JE, Jung KL, Kim SE, et al. 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 Gynaecol Res. 2010; 36: 474–478. 16 Bull C, Assoc BPC. Current and potential impact of fetal diagnosis on prevalence and spectrum of serious congenital heart disease at term in the UK. Lancet. 1999; 354: 1242–1247. 17 Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan atlanta, 1998–2005. J Pediatr. 2008; 153: 807–813. 18 Healthcare Cost and Utilization Project (HCUP). Rockville, MD.: Agency for Healthcare Research and Quality; 1998. Available at: http://www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed August 23, 2013. 1998–2008. 19 Lindinger A, Schwedler G, Hense HW. 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. 2010; 222: 321–326. 20 HCUP Method Series: Changes in the NIS Sampling and Seighting Strategy For 1998; 2008. Availabale at: http://www.hcup-us.ahrq.gov/reports/methods/1998ChangesintheNISRedesignFinal.pdf. Accessed May 18, 2013. 21 Nationwide Inpatient Sample Trends Supplemental (NIS-Trends) Files; 2008. Availabale at: http://www.hcup-us.ahrq.gov/db/nation/nis/nistrends.jsp Accessed May 18, 2013. 22 van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011; 58: 2241–2247. 23 Khoshnood B, Loane M, Garne E, et al. Recent decrease in the prevalence of congenital heart defects in Europe. J Pediatr. 2013; 162: 108–113, e102. 24 Dilber D, Malcic I. Spectrum of congenital heart defects in Croatia. Eur J Pediatr. 2010; 169: 543–550. 25 Hoffman JIE. Natural history of congenital heart disease: problems in its assessment with special reference to ventricular septal defects. Circulation. 1968; 37: 97–125. 26 Moons P, Sluysmans T, De Wolf D, et al. Congenital heart disease in 111,225 births in Belgium: birth prevalence, treatment and survival in the 21st century. Acta Paediatr. 2009; 98: 472–477. 27 Lim MK, Hanretty K, Houston AB, Lilley S, Murtagh EP. Intermittent ductal patency in healthy newborn infants: demonstration by colour Doppler flow mapping. Arch Dis Child. 1992; 67: 1217–1218. 28 McAuliffe FM, Trines J, Nield LE, Chitayat D, Jaeggi E, Hornberger LK. Early fetal echocardiography-a reliable prenatal diagnosis tool. Am J Obstet Gynecol. 2005; 193: 1253–1259. 29 Correa-Villasenor A, McCarter R, Downing J, Ferencz C. White-black differences in cardiovascular malformations in infancy and socioeconomic factors. The Baltimore-Washington infant study group. Am J Epidemiol. 1991; 134: 393–402. 30 Flores G, Bauchner H, Feinstein AR, Nguyen USDT. The impact of ethnicity, family income, and parental education on children's health and use of health services. Am J Public Health. 1999; 89: 1066–1071. Citing Literature Volume10, Issue1January/February 2015Pages 43-50 ReferencesRelatedInformation