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Mortality in infants with cardiovascular malformations

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Abstract

Cardiovascular malformations are an important cause of infant death and the major cause of death due to malformation. Our aims were to analyse and categorise all deaths in infants with cardiovascular malformations, and to analyse trends in mortality over time and influences on mortality. We obtained details of infant deaths and cardiovascular malformations from the population of one health region for 1987–2006. We categorised deaths by cause and by presence of additional chromosomal or genetic abnormalities or non-cardiac malformations. In 676,927 live births the total infant mortality was 4,402 (6.5 per 1,000). A total of 4,437 infants had cardiovascular malformations (6.6 per 1000) of whom 458 (10.3%) died before 1 year of age. Of this number, 151 (33%) deaths had non-cardiac causes, 128 (28%) were cardiac without surgery and 179 (39%) occurred from cardiac causes after surgery. Death was unrelated to the cardiovascular malformation in 57% of infants with an additional chromosomal or genetic abnormality, in 76% of infants with a major non-cardiac malformation and in 16% of infants with an isolated cardiovascular malformation. Terminations of pregnancies affected by cardiovascular malformations increased from 20 per 100,000 registered births in the first 5 years to 78 per 100,000 in the last 5 years. A total of 2,067 infants (47%) underwent surgery and of these 216 (10%) died before 1 year of age. Conclusions: A total of 10.4% of infants who died had a cardiovascular malformation and two-thirds of deaths were due to the malformation or its treatment. Mortality declined due to increasing termination of pregnancy and improved survival after operation.

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Acknowledgements

The Children’s Heart Unit Fund supported J.A.G. and funds the Regional Paediatric Cardiac Database. We are indebted to Mary Bythell of the Regional Maternity Survey Office and to Valerie Sutherland of the Regional Paediatric Cardiology Database for help with the data. We are also indebted to Dr. Sam Richmond and Dr. Judith Rankin for comments on the manuscript. We are grateful to the Link Clinicians in the Northern region for their continued collaboration and support of the Northern Congenital Abnormality Survey (NorCAS). NorCAS is funded by the Healthcare Quality Improvement Partnership.

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Authors and Affiliations

  1. Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK

    Christopher Wren, Claire A. Irving, Josephine Amanda Griffiths, John J. O’Sullivan, Milind P. Chaudhari, Simon R. Haynes, Jon H. Smith, J. R. Leslie Hamilton & Asif Hasan

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  1. Christopher Wren
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  2. Claire A. Irving
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  3. Josephine Amanda Griffiths
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  4. John J. O’Sullivan
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  5. Milind P. Chaudhari
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  6. Simon R. Haynes
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  7. Jon H. Smith
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  8. J. R. Leslie Hamilton
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  9. Asif Hasan
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Correspondence to Christopher Wren.

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Wren, C., Irving, C.A., Griffiths, J.A. et al. Mortality in infants with cardiovascular malformations. Eur J Pediatr 171, 281–287 (2012). https://doi.org/10.1007/s00431-011-1525-3

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  • DOI: https://doi.org/10.1007/s00431-011-1525-3

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