Epidemiology, prenatal diagnosis, and neonatal outcomes of congenital heart defects in eastern China: a hospital-based multicenter study

Xiaohui Zhang; Yu Sun; Jiajun Zhu; Yuning Zhu; Liqian Qiu

doi:10.1186/s12887-020-02313-4

Epidemiology, prenatal diagnosis, and neonatal outcomes of congenital heart defects in eastern China: a hospital-based multicenter study

BMC Pediatr. 2020 Sep 2;20(1):416. doi: 10.1186/s12887-020-02313-4.

Authors

Xiaohui Zhang¹, Yu Sun², Jiajun Zhu³, Yuning Zhu⁴, Liqian Qiu²

Affiliations

¹ Department of Women's Health, Women's Hospital School of Medicine Zhejiang University, Hangzhou, 310006, Zhejiang Province, China. zjfb_amy@zju.edu.cn.
² Department of Women's Health, Women's Hospital School of Medicine Zhejiang University, Hangzhou, 310006, Zhejiang Province, China.
³ Department of Neonatology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.
⁴ Department of Serology Testing, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.

Abstract

Background: Congenital heart defect is the leading malformation in China. There may have been changes in congenital heart defect incidence because of birth policy shift in China over past years. This study aimed to investigate the epidemiology, prenatal diagnosis, and outcomes of congenital heart disease to improve medical and policy decisions.

Methods: Data on cases of congenital heart disease identified during 2014-2018 were taken from the Zhejiang provincial birth defects surveillance system. Chi-square test, odds ratio (OR) and 95% confidence interval (CI) were used to explore epidemiology, prenatal diagnosis, and birth outcomes of congenital heart disease.

Results: The average incidence of congenital heart disease was 16.0 per 1000 births, which increased by 62.2% during 2014-2018(χ²_trend = 181.41, P < 0.001). However, the average critical congenital heart incidence was 1.6 per 1000 births, which remained stable over time. Women aged ≤20 years (OR2.1, 95% CI 1.9-2.3) or ≥ 35 years (OR 1.2, 95% CI 1.2-1.3) were at higher risk of having babies with congenital heart disease than women aged 21-34 years. Women who gave birth in urban areas (OR 1.2, 95% CI 1.2-1.3), had a son (OR 1.3, 95% CI 1.3-1.4), or had multiple births (OR 4.0, 95% CI 3.7-4.4) were also at higher risk than those giving birth in rural areas, to girls, or single births, respectively. The three major subtypes of congenital heart disease were atrial septal defect (67.9%), patent ductus arteriosus (34.7%), and ventricular septal defect (6.4%). The prenatal detection rate of critical congenital heart disease was 90.0%, which was far higher than total congenital heart disease, at 22.2% (χ² = 1687.67, P < 0.001). There were 1457 (17.1%) stillbirths, 106 (1.2%) early neonatal deaths, and 6983 (81.7%) live births associated with congenital heart disease.

Conclusions: The high incidence of congenital heart disease in Zhejiang might be attributable to the large proportion of mild congenital heart disease. The incidence of critical congenital heart disease, the prenatal detection rate, and perinatal deaths from congenital heart disease are comparable to those in other studies.

Keywords: Congenital heart disease; Epidemiology; Neonatal outcome; Prenatal detection.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
China / epidemiology
Female
Heart Defects, Congenital* / diagnostic imaging
Heart Defects, Congenital* / epidemiology
Hospitals
Humans
Incidence
Infant, Newborn
Pregnancy
Prenatal Diagnosis*
Young Adult

Grants and funding

2018YFC1002702/National Key Scientific Instrument and Equipment Development Projects of China (CN)/International