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. 2020 Oct-Dec;13(4):320-326.
doi: 10.4103/apc.APC_35_20. Epub 2020 Sep 17.

Birth prevalence and late diagnosis of critical congenital heart disease: A population-based study from a middle-income country

Mohd Nizam Mat Bah  1 , Mohd Hanafi Sapian  1 , Emieliyuza Yusnita Alias  1
Affiliations

Birth prevalence and late diagnosis of critical congenital heart disease: A population-based study from a middle-income country

Mohd Nizam Mat Bah et al. Ann Pediatr Cardiol. 2020 Oct-Dec.

Abstract

Aims: There are limited data regarding critical congenital heart disease (CCHD) from middle-income countries (MIC). This study aims to determine the birth prevalence, rate of late diagnosis, and influence of timing of diagnosis on the outcome of CCHD.

Setting and design: Retrospective observational cohort study in the State of Johor, Malaysia.

Subjects and methods: All infants born between January 2006 and December 2015 with a diagnosis of CCHD, defined as infants with duct-dependent lesions or cyanotic heart disease who may die without early intervention. The late diagnosis was defined as a diagnosis of CCHD after 3 days of age.

Results: Congenital heart disease was diagnosed in 3557 of 531,904 live-born infants and were critical in 668 (18.7%). Of 668, 347 (52%) had duct-dependent pulmonary circulation. The birth prevalence of CCHD was 1.26 (95% confidence interval: 1.16-1.35) per 1000 live births, with no significant increase over time. The median age of diagnosis was 4 days (Q1 1, Q3 26), with 61 (9.1%) detected prenatally, and 342 (51.2%) detected late. The highest rate of late diagnosis was observed in coarctation of the aorta with a rate of 74%. Trend analysis shows a statistically significant reduction of late diagnosis and a significant increase in prenatal detection. However, Cox regression analysis shows the timing of diagnosis does not affect the outcome of CCHD.

Conclusions: Due to limited resources in the MIC, the late diagnosis of CCHD is high but does not affect the outcome. Nevertheless, the timing of diagnosis has improved over time.

Keywords: Birth prevalence; critical congenital heart disease; late diagnosis; middle-income country.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The trend over time of birth prevalence and rate of late diagnosis (diagnosis after 3 days of life) of critical congenital heart disease
See this image and copyright information in PMC

References

    1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900. - PubMed
    1. van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:2241–7. - PubMed
    1. GBD 2017 Congenital Heart Disease Collaborators. Global, regional, and national burden of congenital heart disease, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet Child Adolesc Health. 2020;4:185–200. - PMC - PubMed
    1. Brown KL, Ridout DA, Hoskote A, Verhulst L, Ricci M, Bull C. Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart. 2006;92:1298–302. - PMC - PubMed
    1. Fixler DE, Xu P, Nembhard WN, Ethen MK, Canfield MA. Age at referral and mortality from critical congenital heart disease. Pediatrics. 2014;134:e98–105. - PubMed