Mortality from Congenital Heart Disease in Mexico: A Problem on the Rise

Abstract

Background and ObjectivesTemporal trends in mortality from congenital heart disease (CHD) vary among regions. It is therefore necessary to study this problem in each country. In Mexico, congenital anomalies were responsible for 24% of infant mortality in 2013 and CHD represented 55% of total deaths from congenital anomalies among children under 1 year of age. The objectives of this study were to analyze the trends in infant mortality from CHD in Mexico (1998 to 2013), its specific causes, age at death and associated socio-demographic factors.MethodsPopulation-based study which calculated the compounded annual growth rate of death rom CHD between 1998 and 2013. Specific causes, age at which death from CHD occurred and risk factors associated with mortality were analyzed for the year 2013.ResultsInfant mortality from CHD increased 24.8% from 1998 to 2013 (114.4 to 146.4/ 100,000 live births). A total of 3,593 CHD deaths occurred in 2013; the main causes were CHD with left-to-right shunt (n = 487; 19.8/100,000 live births) and cyanotic heart disease (n = 410; 16.7/100,000). A total of 1,049 (29.2%) deaths from CHD occurred during the first week of life. Risk factors associated with mortality from CHD were, in order of magnitude: non-institutional birth, rural area, birth in a public hospital and male sex.ConclusionsMortality from CHD has increased in Mexico. The main causes were CHD with left-to-right shunt, which are not necessarily fatal if treated promptly. Populations vulnerable to death from CHD were identified. Approximately one-third of the CHD occurred during the first week of life. It is important to promote early diagnosis, especially for non-institutional births.

Mortality trends from congenital malformations of the heart and the great vessels in children and adults in the seven socioeconomic regions of Mexico, 2000‐2015

“…Diabetes and substance abuse, both known to be associated with CHD, are more prevalent now in women of reproductive age than 10 years ago. In addition, the number of specialists per capita has increased in recent years; therefore, it is possible that deaths from CHD that were not previously detected are now diagnosed and recorded as causes of infant mortality …”

“…In other studies, conducted in Mexico, very similar results have been found in children <1 year of age. In the year 2013, it was seen that out of the four regions (North, South, Center, and Mexico City), Mexico City had the highest mortality rate with 188.5 per 100 000 live births, which could be due to genetic or environmental factors, or to underreporting of deaths in states with fewer resources . The obesity epidemic with phenotypes associated with diabetes mellitus and hypercholesterolemia are considered as emerging risk factors for CHD .…”

“…In addition, the number of specialists per capita has increased in recent years; therefore, it is possible that deaths from CHD that were not previously detected are now diagnosed and recorded as causes of infant mortality. 3 In the 2000-2015 study period, more men (37 828 [53.5%]) than women (32 913 [46.5%]) died from CHD ( 14 identified as the five most frequent CHD:…”

“…There was also a decrease in mortality from CHD in the United States between 1970 and 1997, which contributed to a reduction of 59% in infant mortality during this period. In contrast, the overall mortality rate for CHD in China increased 62% between 2003 and 2010 …”

“…In the year 2000, 2596 children <1 year of age died of CHD, which accounts for 6.7% of the total deaths in this age group. In 2008, mortality from CHD increased to 2848, which accounts for 9.6% of the total …”