Elsevier

The Journal of Pediatrics

Volume 153, Issue 6, December 2008, Pages 807-813
The Journal of Pediatrics

Original article
Prevalence of Congenital Heart Defects in Metropolitan Atlanta, 1998-2005

https://doi.org/10.1016/j.jpeds.2008.05.059Get rights and content

Objective

To determine an accurate estimate of the prevalence of congenital heart defects (CHD) using current standard diagnostic modalities.

Study design

We obtained data on infants with CHD delivered during 1998 to 2005 identified by the Metropolitan Atlanta Congenital Defects Program, an active, population-based, birth defects surveillance system. Physiologic shunts in infancy and shunts associated with prematurity were excluded. Selected infant and maternal characteristics of the cases were compared with those of the overall birth cohort.

Results

From 1998 to 2005 there were 398 140 births, of which 3240 infants had CHD, for an overall prevalence of 81.4/10 000 births. The most common CHD were muscular ventricular septal defect, perimembranous ventricular septal defect, and secundum atrial septal defect, with prevalence of 27.5, 10.6, and 10.3/10 000 births, respectively. The prevalence of tetralogy of Fallot, the most common cyanotic CHD, was twice that of transposition of the great arteries (4.7 vs 2.3/10 000 births). Many common CHD were associated with older maternal age and multiple-gestation pregnancy; several were found to vary by sex.

Conclusions

This study, using a standardized cardiac nomenclature and classification, provides current prevalence estimates of the various CHD subtypes. These estimates can be used to assess variations in prevalence across populations, time, or space.

Section snippets

Methods

MACDP is a population-based surveillance system for major structural birth defects, chromosomal abnormalities, and clinical syndromes established in 1967 by the Centers for Disease Control and Prevention (CDC), Emory University, and the Georgia Mental Health Institute.8 Since that time, the program has conducted surveillance for birth defects among liveborn and stillborn infants greater than or equal to 20 weeks' gestation born to residents of the 5 central counties of metropolitan Atlanta

Results

During 1998 to 2005, there were 3240 infants identified with CHD and 398 140 live births in metropolitan Atlanta. The overall prevalence of CHD was 81.4 infants/10 000 births, and the prevalence of critical CHD was 15.6 infants/10 000 births (Table II). Because some infants had more than 1 independent CHD, the sum of individual CHD prevalence is greater than the total CHD prevalence.

The left-to-right shunt lesions were the most prevalent group of defects, comprising more than half of the total

Discussion

Our study provides prevalence estimates for several CHD that were not previously discussed in the Hoffman and Kaplan4 review (Table II), including subtypes of septal defects and rare defects such as discordant atrioventricular connections (congenitally corrected TGA), heterotaxy syndrome, and interrupted aortic arch type B, using the STS nomenclature and classification system. The most common defects were muscular VSD, perimembranous VSD, and secundum ASD with prevalence estimates of 27.5,

References (22)

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    Supported by National Institute of Environmental Health Sciences (NIEHS) grant R01-ES012967-01A1.

    The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. The authors declare no potential conflicts of interest.

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