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Aim: To assess basic trends in epidemiology of congenital heart defects CHDs. Method: Population based prospective observational study. Material: CHDs in infants born alive in a Norwegian county 1982-2011. Results: In 828-71 217 infants 12 per 1000 a CHD was diagnosed. The prevalence increased from 8 to 12 per 1000 after introduction of early echocardiography in newborns with suspected CHD from 1986 p = 0.0001. Ventricular septal defect VSD was the dominating CHD 474; 57%. In 222 27% the CHDs were missed and diagnosed after discharge from hospital after birth. Twelve critical CHDs causing death or requiring invasive procedures before 28 days of life were missed. Prenatal diagnosis of critical CHDs increased from 4-67 6% born 1997-2006 to 4-11 36% born 2007-2011 p = 0.01. In 177 21% a syndrome or extracardial defect occurred. The occurrence of CHDs associated with chromosomal disorders 60-73 82% trisomies more than doubled from the cohort born in the first 10-year period 1982-1991 0.6 per 1000 to the last 2002-2011 1.4 per 1000 p < 0.0001 in parallel with increasing births in women ≥ 35 years old in the population. 237 29% underwent therapeutic procedures 203 86% surgery, of whom 16 after initial catheter intervention, and 34 14% catheter intervention alone. 39-237 16% died, 101 43% were repaired and 97 41% had some minor residual defect. The death rate declined significantly from 65-532 12% born 1982-2001 to 11-296 4% born 2002-2011 p = 0.0001. 37-76 49% deaths occurred within 28 days after birth. Conclusions: The rate of detection of CHDs increased substantially after introduction of echocardiography in newborns with suspected CHD, especially VSDs. Some critical CHDs were overlooked. The prenatal detection rate of such defects increased. The prevalence of CHDs with associated chromosomal disorders increased in parallel with increasing maternal age in the population. Most deaths occurred during the neonatal period. Increasing survival increases the load on long-term follow-up programmes.

KEYWORDS

Congenital Heart Defects; Prevalence; Associated Malformations; Spontaneous Cure; Surgery; Outcome

Cite this paper

Meberg, A. 2012 Congenital heart defects through 30 years. Open Journal of Pediatrics, 2, 219-227. doi: 10.4236-ojped.2012.23035.





Autor: Alf Meberg

Fuente: http://www.scirp.org/



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