Original Article
Prevalence of Congenital Heart Disease at Live Birth in Taiwan

https://doi.org/10.1016/j.jpeds.2009.11.062Get rights and content

Objectives

To investigate the prevalence at live birth of congenital heart disease (CHD) in Taiwan.

Study design

Patients with CHD born from 2000 to 2006 were identified from National Health Insurance databases.

Results

CHD prevalence was 13.08 per 1000 live births: 12.05 (simple, 10.53; severe, 1.51) in male infants and 14.21 (simple, 12.90; severe, 1.32) in female infants. Ventricular septal defect (VSD; 4.0) was the most common defect, followed by secundum atrial septal defect (ASDII; 3.2), patent ductus arteriosus (PDA; 2.0), pulmonary stenosis (PS; 1.2), tetralogy of Fallot (TOF; 0.63), coarctation of aorta (CoA; 0.25), transposition of great arteries (TGA; 0.21), endocardial cushion defect (ECD; 0.20), double outlet of right ventricle (DORV; 0.15), total anomalous pulmonary venous return (TAPVR; 0.11), aortic stenosis (0.09), hypoplastic left heart syndrome (HLHS; 0.062), Ebstein anomaly (0.047), and tricuspid atresia (0.046). Female predominance was observed in VSD, ASDII, PDA, and ECD; and male predominance was observed in TGA and TOF. Ratios of western prevalence to our Asian prevalence were high for HLHS (3.68-4.5), CoA (1.13-1.96), TGA (1.09-1.83), and tricuspid atresia (1.09-2.57), but low for PS (0.15-0.99), TOF (0.41-0.92), and possibly ASDII.

Conclusions

In this Asian population, the prevalence of CHD was at the high end of the reported range, with more PS and TOF, but fewer left-sided obstructions, TGA, and tricuspid atresia.

Section snippets

Methods

Taiwan is an island country with an area of 36 188 km,2 and the population is approximately 22.6 million. There are 23 academic medical centers, 80 regional hospitals, and 435 district hospitals. The average annual number of live births from 2000 to 2006 was 238 143 (124 542 male infants and 116 965 female infants). A nationwide National Health Insurance (NHI) program was implemented in Taiwan in 1995 and covered 97.47% of the Taiwan population between 2000 and 2006. From the health care

Results

The prevalence of CHD and each specific subtype of CHD is shown in Table I. Because there may be >1 diagnosis of each subtype of CHD in 1 patient, the number of patients with CHD is lower than the sum of each subtype of CHD. The prevalence of CHD was 13.08 (simple, 11.66; severe, 1.42) per 1000 live births, 12.05 (simple, 10.53; severe, 1.51) in male infants and 14.21 (simple, 12.90; severe, 1.32) in female infants. The most common subtype of CHD was VSD, which occurred in 4.01 per 1000 live

Discussion

In the review by Hoffman and Kaplan, the prevalence of CHD was found to be positively related to the relative frequency of VSD.5 In this study, the relationship between VSD to all CHD also fit the plots published by Hoffman and Kaplan.5 Our CHD prevalence was quite close to that reported by Nakazawa et al from Japan.7 On the basis of clinical assessment of 72 745 live births from 1984 to 1985, they found a CHD prevalence of 10.6 per 1000 live births.7 Therefore, the CHD prevalence of Taiwan is,

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The authors declare no conflicts of interest.

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