Epidemiology, prenatal diagnosis, and neonatal outcomes of congenital heart defects in eastern China: a hospital-based m
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RESEARCH ARTICLE
Open Access
Epidemiology, prenatal diagnosis, and neonatal outcomes of congenital heart defects in eastern China: a hospital-based multicenter study Xiaohui Zhang1* , Yu Sun1, Jiajun Zhu2, Yuning Zhu3 and Liqian Qiu1
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(χ2trend = 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, Prenatal detection, Neonatal outcome
* Correspondence: [email protected] 1 Department of Women’s Health, Women’s Hospital School of Medicine Zhejiang University, Hangzhou 310006, Zhejiang Province, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Cr
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