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Evaluation of the General Practice Research Database congenital heart defects prevalence: comparison to United
Keele E Wurst1, Sara A Ephross, James Loehr
1University of North Carolina, Chapel Hill, North Carolina 27709, USA. keele.e.wurst@gsk.com
Insights
The General Practice Research Database (GPRD) shows higher congenital heart defect rates than UK national systems, making it a valuable source for pregnancy medication studies.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- Validating the General Practice Research Database (GPRD) for medication use in pregnancy studies.
- Assessing the similarity of congenital heart defect (CHD) rates between GPRD and UK national systems.
Purpose of the Study:
- To compare CHD prevalence rates from GPRD with national surveillance systems (NCAS and EUROCAT).
- To determine if GPRD is a reliable data source for CHD research.
Main Methods:
- Prevalence rates of heart defects (2001-2003) were extracted from GPRD.
- GPRD data compared with National Congenital Anomaly System (NCAS) and European Concerted Action of Congenital Anomalies and Twins (EUROCAT).
- Rate ratios (RRs) and 95% CIs calculated; effect of child's age on GPRD frequency analyzed.
Main Results:
- GPRD showed significantly higher prevalence of heart defects (over double NCAS, slightly higher than EUROCAT).
- Prevalence of specific heart defects varied across the three data sources.
- Congenital heart defect prevalence in GPRD was higher when including children up to age 6.
Conclusions:
- GPRD provides a more complete background prevalence for common congenital heart defects.
- This enhanced completeness is crucial for assessing associations between maternal exposures and CHDs.
- GPRD validation supports its use in future research on pregnancy and medication safety.
Background:
As part of an effort to validate the General Practice Research Database (GPRD) for future studies of medication use in pregnancy, this study examined whether the rates of all, and specific types of, congenital heart defects obtained from the GPRD are similar to those obtained from UK national systems.
Methods:
The prevalence rates of heart defects for 2001-2003 were determined from the GPRD and compared with both the National Congenital Anomaly System (NCAS) and the European Concerted Action of Congenital Anomalies and Twins (EUROCAT). Rate ratios (RRs) and 95% CIs were calculated comparing the prevalence of all congenital heart defects as well as specific types of heart defects in the three data sources. In addition, the effect of the child's age on the frequency of heart defects in the GPRD was determined.
Results:
The prevalence of heart defects in the GPRD was more than twice as high as in the NCAS and slightly higher than in the EUROCAT. All differences were statistically significant. The prevalence of specific heart defects varied across the GPRD, NCAS, and EUROCAT. The measured prevalence of congenital heart defects in the GPRD was higher if calculated including children up to age 6.
Conclusions:
The comparisons of the GPRD prevalence rates to national prevalence estimates demonstrate that the GPRD can serve as a more complete source of background prevalence for the most commonly occurring congenital heart defects, which is essential to properly assess possible associations between maternal exposures and congenital heart defects.
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