Epidemiology and major subtypes of congenital heart defects in Hunan Province, China

Abstract

Congenital heart defects (CHDs) are the most common birth defects (BDs) and account for nearly one-third of all BDs. The aim of this article was to investigate the epidemiology and major subtypes of CHDs in Hunan Province, China in the last 5 years.CHD surveillance data from 2012 to 2016 were collected from 52 registered hospitals in Hunan. The prevalence rates of CHDs, incidence rates of CHDs combined with other BDs, and rates of termination of pregnancy (TOP) for CHDs among different regions, infant sexes, and maternal ages were calculated for both early fetuses (<28 weeks of gestation) and perinatal infants (PIs) (between 28 weeks of gestation and 7 days after birth). Both the constituent ratio and prevalence rates were computed among subtypes.CHDs were found in 6289 out of 673,060 births. The overall prevalence was 93.44 per 10,000 PIs, with 19.27 and 74.17 per 10,000 in early fetuses and PIs, respectively. The risks of CHDs were higher in infants from urban areas than those from rural areas during the whole gestation and were higher in male infants than in female infants during the perinatal period. The total prevalence of CHDs increased significantly with maternal age (χ2 trend = 141.84, P < .05). Among fetuses in early gestation, there were 288 cases (22.21%) of CHDs combined with other BDs and 1292 cases (99.61%) of TOP for CHD. The 3 major subtypes of CHDs were ventricular septal defect (VSD) (22.06%), Tetralogy of Fallot (TOF) (9.43%), and atrioventricular septal defect (AVSD) (6.69%). Among PIs, there were 1541 cases (30.87%) of CHD diagnosed before delivery and 1184 cases (76.83%) were TOP. The 3 major subtypes were atrial septal defect (ASD) (42.81%), patent ductus arteriosus (PDA) (16.07%), and VSDs (15.21%).The total prevalence of CHD in Hunan Province and the rate of TOP for CHD was high, especially for early-gestation fetuses. Pregnancies in urban women, male PIs, and maternal age were the risk factors for CHDs. Among early-gestation fetuses, the most common types were VSD, TOF, and ASD, and among PIs, the most common types were ASD, PDA, and VSD.

Epidemiology, Prenatal Diagnosis, and Neonatal Outcomes of Congenital Heart Defects in Eastern China: A Hospital-Based Multicenter Study

“…The increased risk of birth defects in younger women possibly result from their unhealthy lifestyle, insufficient ANC or low socioeconomic status. Births in urban areas had higher risks of CHD than those in rural areas, similar to findings in Langfang and Hunan [16,17].Women in urban areas may have easy access to high quality ANC, which can lead to a higher detection rate of CHD. Further, environmental exposure and social pressure from urban life should be considered.…”

“…It has been widely reported that CHD increased with maternal age [15,16,24]. Simultaneously, several studies have also indicated negative associations between teenage pregnancy and congenital anomalies [25,26].…”

“…China is facing a great burden of CHD for its huge population, where the prevalence of CHD vary from 7.6 to 22.9 per 1000 live births or perinatal infants in previous researches [14][15][16][17][18][19]. Studies on the epidemiology of CHD in China usually focus on births at and over 28 gestational weeks, and to fully understand the occurrence of CCHD is limited.…”

Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography

“…A VSD is a common congenital heart disease. [1,2] The conventional treatments include surgical repair and transcatheter device closure. Both treatments have their own merits and demerits with satisfactory therapeutic effects and have been widely used for a long time.…”

“…Ventricular septal defects (VSDs) are one of the most common congenital heart diseases with approximately two cases per 1,000 live births. [1,2] Transcatheter device closure and conventional surgical repair for VSDs have been successfully used and reliably proven with minimal morbidity and no mortality. [3][4][5][6] These two treatments have their own advantages and disadvantages and have their own irreplaceable characteristics.…”