Birth prevalence of congenital heart defects in Western Australia, 1990-2016.

Autor: Hansen M; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia., Greenop K; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia., Yim D; Department of Paediatric Cardiology, Perth Children's Hospital, Perth, Western Australia, Australia., Ramsay J; Department of Paediatric Cardiology, Perth Children's Hospital, Perth, Western Australia, Australia., Thomas Y; Western Australian Register of Developmental Anomalies, King Edward Memorial Hospital, Perth, Western Australia, Australia., Baynam GS; Western Australian Register of Developmental Anomalies, King Edward Memorial Hospital, Perth, Western Australia, Australia.; Telethon Kids Institute and Division of Paediatrics, Faculty of Health and Medicine, University of Western Australia, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Journal of paediatrics and child health [J Paediatr Child Health] 2021 Oct; Vol. 57 (10), pp. 1672-1680. Date of Electronic Publication: 2021 May 29.
DOI: 10.1111/jpc.15592
Abstrakt: Aim: To describe the birth prevalence and characteristics of congenital heart defects in a geographically defined Australian population.
Methods: This descriptive, population-based study examined congenital heart defects in live births, stillbirths and pregnancy terminations ascertained by the Western Australian Register of Developmental Anomalies, 1990-2016. Birth prevalence (per 1000 births) was stratified by severity, known cause, maternal and birth characteristics, and primary diagnosis; and prevalence ratios were calculated for Aboriginal versus non-Aboriginal births. Temporal trends in prevalence, diagnosis age and infant mortality were examined.
Results: For births 1990-2010 (allowing 6 years for complete case ascertainment by 2016), 6419 cases were identified; prevalence was 11.5 per 1000 births (95% confidence interval (CI), 11.2-11.8). Severe defects were ascertained in 2.5 per 1000 births (95% CI 2.4-2.7). Most cases were liveborn (5842, 91.0%), and 28.9% had other birth defects. Prevalence was slightly higher in Aboriginal births (prevalence ratio 1.1; 95% CI 1.0-1.2); and the infant mortality rate more than doubled (13.4% vs. 5.8%, P < 0.001). Prenatal diagnosis increased over time but, in remote areas, was significantly lower for Aboriginal versus non-Aboriginal cases (3.1% vs. 9.3%; P = 0.008). A cause was identified in 920 cases (14.3%), more often for severe defects (347, 24.4%); 63% of known causes were rare diseases. Congenital heart defects associated with fetal alcohol spectrum disorder were much more common in Aboriginal births (prevalence ratio 82; 95% CI 28-239).
Conclusions: Earlier detection of congenital heart defects and improved survival has occurred over time, although discrepancies between ethnic groups and regions warrant further investigation and strategic action.
(© 2021 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Databáze: MEDLINE
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