Risk of perinatal deaths for fetuses and early newborns with congenital heart defects

Abstract

Background There are few studies on perinatal death with congenital heart defects (CHDs). This study analyzed the epidemiological features of CHD and the risk of perinatal death for fetuses and early newborns with CHDs. Methods We used data from the Birth Defects Surveillance System of Hunan Province, China, from 2016 to 2020. The surveillance data of perinatal infants (for stillbirth, dead fetus, or live birth between 28 weeks of gestation and seven days after birth) were analyzed. We computed the CHD prevalence and 95% confidence intervals (CI) by Poisson regression and analyzed the epidemiological features of perinatal deaths with CHD. Results From 2016 to 2020, a total of 847755 perinatal infants were registered, 14459 cases of birth defects and 4161 cases of CHDs were reported. The CHD prevalence was 4.908‰. Among the 4161 cases of CHDs, 976 cases (23.46%) of perinatal deaths were reported, and 941 cases (96.41%) of perinatal deaths were electively terminated of pregnancy. A relatively high proportion of perinatal deaths occurred in the maternal age group <20 and 20-24 years old. The CHD prevalence was higher in urban areas than in rural areas (6.844‰ vs. 3.598‰) (P<0.05). The most frequent CHD subtypes were ventricular septal defect (VSD), atrial septal defect (ASD), tetralogy of Fallot (TOF), and atrioventricular septal defect (AVSD), which accounted for 56.36%, 12.28%, 3.51% and 2.14% of total CHDs, respectively, and the prevalences were 2.766‰, 0.603‰, 0.172‰, and 0.105‰, respectively. The proportions of perinatal deaths with VSD (9.72%) and ASD (2.74%) were relatively low, while TOF (67.81%) and AVSD (34.83%) were relatively high. Low maternal age, rural residents, low income, low maternal educational background, zero parity, and low gestational age of diagnosis were risk factors for perinatal death. Conclusion Our study has revealed the CHD prevalence, major subtypes, and the proportion of perinatal deaths. Furthermore, we have identified risk factors for perinatal death due to CHD. It may be helpful for clinical and public health decisions.