Presentation of congenital heart disease diagnosed at birth: analysis of 29,770 newborn infants

Abstract

Methods:A retrospective, database driven study, part of the LatinAmerican collaborative study of congenital malformations. Records were reviewed on all live born (LB) and stillborn (SB) infants with congenital heart diseases diagnosed by postnatal echocardiogram or by autopsy. Data on birth weight, sex, age and parity were collected for the LB and studied for associations. The statistical analysis employed Pearson's chisquare test and multinomial logistic regression.Results: During the period studied there were 29,770 births (28,915 LB and 855 SB). The prevalence of heart disease among the LB was 9.58:1,000 (277/28,915) while among SB the rate was 87.72:1,000 (75/ 855). Heart disease occurred isolated in 37.2% of LB cases and 18.7% of SB cases; was associated with anomalies of other organs and systems, but without a syndromic diagnosis in 31.4% of LB cases and 48.0% of SB cases; and in 23.1% of the LB cases and 32.0% of the SB cases the heart disease was a feature of a syndrome. Multivariate analysis demonstrated an association between heart disease and birth weight ≤ 2,500 g in all types of clinical presentation, between maternal age ≥ 35 years and heart disease in syndromic heart disease and between female sex and isolated heart disease. Conclusions:It was found a high prevalence, which is an alert to the medical significance of heart disease. There was association between birth weight ≤ 2,500 g and all forms of presentation, between increased maternal age and syndromic heart disease besides between female sex and isolated congenital heart disease. J Pediatr (Rio J). 2008;84(1):83-90:Congenital heart disease, prevalence, abnormalities, etiology. Artigo submetido em 28.09.07, aceito em 06.11.07.

Observed Prevalence of Congenital Heart Defects From a Surveillance Study in China

“…The total observed prevalence of congenital heart defects was higher than that found in other studies, 15,[20][21][22][23][24] primarily because of the large number of minor defects that were diagnosed postnatally on neonatal echocardiography. Ventricular septal defects were the most common defects, accounting for 62.7% of all cases.…”

“…Conversely, the prevalence of major defects was 3.0 per 1000, 75% of which were diagnosed prenatally by fetal echocardiography. The prenatal detection rate for minor defects was significantly lower than the rate for major defects.The total observed prevalence of congenital heart defects was higher than that found in other studies, 15,[20][21][22][23][24] primarily because of the large number of minor defects that were diagnosed postnatally on neonatal echocardiography. Ventricular septal defects were the most common defects, accounting for 62.7% of all cases.…”

Cardiopatias congênitas em um serviço de referência: evolução clínica e doenças associadas

“…Two Brazilian studies analyzed prevalence of congenital heart diseases in alive newborns and identified 5.5:1,000 newborns between 1989 and 1998 3 and 9.58:1,000 newborns between 1990 and 2003 4 . These malformations can be isolated cases, part of syndromes or results of genetic diseases, such as deletion of chromosomal regions, or it can be caused by environmental factors (use of teratogenic drugs by mothers, infections during pregnancy) 5 .…”

Malformações detectadas pelo ultrassom abdominal em crianças com cardiopatia congênita

“…In a literature review, only two publications in English language were found with similar goal to our study, that was to evaluate presence of abdominal malformations in patients with CHD through AUS 9,10 . In contrast, our study is unique in that all CHD patients underwent AUS, high resolution karyotype and FISH for detection of microdeletion 22q11.2, and all were examined by a clinical geneticist 7,[8][9][10][18][19][20][21][22][23][24][25][26][27][28][29][30] .…”

“…In the study of Muragasu et al 10 , the patients were submitted only to the ultrasound study of the urinary tract, and 11.9% clinically significant abnormalities were found. Most of the other studies that described extracardiac malformations in patients with CHD did not indicate which methods were used to detect abdominal abnormalities, and were performed retrospectively through review of patient records 7,18,[21][22][23][24][25][27][28][29][30] .…”