Increased prevalence of ventricular septal defect: epidemic or improved diagnosis

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Updated: Sep 23, 2026

Murine Fetal Echocardiography
08:04

Murine Fetal Echocardiography

Published on: February 15, 2013

G R Martin1, L W Perry, C Ferencz

  • 1Department of Pediatric Cardiology, George Washington University, Washington, DC.

Pediatrics
|February 1, 1989
PubMed

Insights

An increase in infant ventricular septal defects was observed, but this rise in congenital heart defects is attributed to improved echocardiography detection, not an epidemic. Early diagnosis of isolated defects has increased.

Area of Science:

  • Pediatric Cardiology
  • Epidemiology
  • Medical Diagnostics

Background:

  • The Baltimore-Washington Infant Study monitors congenital cardiovascular malformations.
  • An increase in ventricular septal defects (VSDs) was noted between 1981 and 1984.

Purpose of the Study:

  • To investigate the rise in VSD prevalence among infants.
  • To determine if the increase in congenital heart defects signifies an epidemic.

Main Methods:

  • A case-control study analyzing data from 1,494 infants with confirmed diagnoses.
  • Diagnoses confirmed via echocardiography, catheterization, surgery, or autopsy.
  • Prevalence rates per 1,000 live births were calculated and compared over time.

Main Results:

  • Overall congenital cardiovascular malformations increased from 3.6 to 4.5 per 1,000 live births (P < .025).
  • VSD prevalence rose from 1.0 to 1.6 per 1,000 live births (P < .001), accounting for the total increase.
  • Isolated VSD prevalence increased significantly (0.67 to 1.17 per 1,000 live births, P < .001).
  • No change in VSD with specific co-occurring conditions; no change in VSDs diagnosed via catheterization, surgery, or autopsy.
  • VSDs diagnosed by echocardiography increased from 0.30 to 0.70 per 1,000 live births (P < .001).

Conclusions:

  • The reported increase in VSD prevalence is primarily due to enhanced detection of small, isolated defects using echocardiography.
  • There is no evidence to support an epidemic of congenital heart defects.
  • Improved diagnostic capabilities, particularly echocardiography, are key to understanding changing prevalence rates.

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