Trends in congenital heart disease in Dallas County births. 1971-1984.

Abstract

To examine the changes in birth cohort prevalence rates and severity of congenital heart disease, we studied children with congenital heart disease born to blacks, whites, and Mexican-Americans in Dallas County from 1971 through 1984. Diagnoses were made by pediatric cardiologists' clinical evaluations, echocardiography, catheterization, surgery, or autopsy. During this study period, 2,509 of 379,561 liveborn infants were diagnosed, a prevalence rate of 6.6/1000. The rates for whites was significantly higher than for blacks or Mexican-Americans -7.2/1,000, 5.6/1,000, and 5.911,000, respectively. The rate for severe cases requiring cardiac catheterization or surgery or undergoing autopsy was 3.111,000 and did not differ among the three groups. The time trend for rates of congenital heart disease suggested an apparent increase in prevalence rate during the 1970s; however, the prevalence rate of severe forms remained relatively stable. This indicates that the apparent rise in prevalence could be accounted for by an increase in detection of mild cases. These findings were interpreted as reflecting a greater tendency for pediatricians to refer asymptomatic children with significant heart murmurs to a pediatric cardiologist. (Circulation 1990;81:137-142) C ongenital heart disease (CHD) is a leading cause of death during the first year of life. Malformations of the cardiovascular system are also associated with significant medical morbidity, which requires use of costly medical facilities. Children with CHD use 25-30% of the beds in most large pediatric intensive care units and, therefore, consume a large fraction of pediatric health care resources. To plan future health care needs, epidemiologic data are needed regarding changes in prevalence and severity of CHD. The surveillance systems for birth defects conducted by the Centers for Disease Control have indicated a more than twofold increase in the most common form of CHD, ventricular septal defect, between-1970 and 1977.1 To examine the changes in prevalence rates and severity of CHD, we gathered epidemiologic data on children with CHD who were born in a well-defined geographic area during a specific time period. The

Racial and Temporal Variations in the Prevalence of Heart Defects

“…Investigators in North America and elsewhere noted an increase in specific heart defects, including pulmonic stenosis and ventricular, atrial, and atrioventricular septal defects, [7][8][9]19,20 during the 1970s and 1980s. [7][8][9]11,19,[21][22][23] Our findings document a continuation of such trends well into the 1990s.…”

Prevalence of congenital heart diseases in Mysore

“…[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] [ Table 2] shows the prevalence of CHDs in India. [7][8][9][25][26][27][28][29][30] Studies in Chandigarh showed the maximum prevalence of 50.89 per 1000 live births [9] whereas studies in Shimla showed the minimum of 2.25 per 1000 live births.…”

Epidemiology and Etiology of Congenital Heart Diseases

“…Finally, the rapid development of the world may increase many risk factors to develop CHD such as pollutants and teratogens. The number of births with CHD in Dallas county suggests an apparent increase in prevalence from approximately 5% in 1971 to 8% in 1984 (Fixler et al, 1990). Within the Baltimore-Washington Infant Study Group, the prevalence of CHD increased from 2.8 per 1,000 live births in 1981 to 4.3 per 1,000 live births in 1988 (Ferencz et al, 1989) and a recent report from North England demonstrated the total prevalence of CHD increased from 5.4 per 1,000 births and terminations of pregnancy in 1985 to 11.6 per 1,000 births and terminations of pregnancy in (Dadvand et al, 2008.…”