Incidence and mortality trend of congenital heart disease at the global, regional, and national level, 1990-2017

Abstract

Congenital heart disease (CHD) is the most commonly diagnosed congenital disorder in newborns. The incidence and mortality of CHD vary worldwide. A detailed understanding of the global, regional, and national distribution of CHD is critical for CHD prevention.We collected the incidence and mortality data of CHD from the Global Burden of Disease study 2017 database. Average annual percentage change was applied to quantify the temporal trends of CHD incidence and mortality at the global, regional, and national level, 1990-2017. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.The incidence of CHD was relatively high in developing countries located in Africa and Asia, while low in most developed countries. Between 1990 and 2017, the CHD incidence rate remained stable at the global level, whereas increased in certain developed countries, such as Germany and France. The age-standardized mortality rate of CHD declined substantially over the last 3 decades, regardless of sex, age, and SDI region. The decline was more prominent in developed countries. We also detected a significant positive correlation between CHD incidence and CHD mortality in both 1990 and 2017, by SDI.The incidence of CHD remained stable over the last 3 decades, suggesting little improvement in CHD prevention strategies and highlighting the importance of etiological studies. The mortality of CHD decreased worldwide, albeit the greatly geographical heterogeneity. Developing countries located in Africa and Asia deserve more attention and priority in the global CHD prevention program.

Figure 1

Flow diagram of the study design.

Figure 2

(A, B) The incidence and mortality rate of congenital heart disease between 1990 and 2017, by sex and socio-demographical index (SDI) region.

Figure 3

(A) The incidence rate of congenital heart disease (CHD) by location, in 2017. Rate is per 1000 population. (B) The average annual percentage change (AAPC) of CHD incidence rate by location, between 1990 and 2017. (C) The mortality rate of CHD by location, in 2017. Rate is per 100,000 population. (D) The AAPC of CHD mortality rate by location, between 1990 and 2017.

Figure 4

The association between congenital heart disease (CHD) incidence and CHD mortality. The CHD mortality rates were positively related to the CHD incidence rate in both 1990 and 2017, by socio-demographical index (SDI) region.