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Evaluation of a temporal increase in ventricular septal defects: estimated prevalence and severity in northeastern
E W Spooner1, E B Hook, M A Farina
1Department of Pediatrics, Albany Medical Center Hospital, New York.
Insights
The prevalence of isolated ventricular septal defects (VSD) in infants increased fourfold from 1970 to 1983. This study found no evidence that increased diagnostic intensity explains this trend in pediatric cardiology.
Area of Science:
- Pediatric Cardiology
- Public Health
- Epidemiology
Background:
- A significant rise in ventricular septal defects (VSD) diagnoses has been reported nationally.
- Pediatric cardiologists suggest increased diagnostic evaluation may explain this trend.
- Objective evidence supporting this explanation is lacking.
Purpose of the Study:
- To investigate the trend of isolated ventricular septal defects (VSD) in infants.
- To assess whether increased diagnostic intensity explains the rising VSD prevalence.
- To analyze VSD diagnosis rates in a defined geographic area over time.
Main Methods:
- Retrospective analysis of live birth records from 1970-1983 in Albany, New York counties.
- Inclusion criteria: VSDs diagnosed under 1 year of age, unassociated with cardiac syndromes.
- Exclusion criteria: VSDs part of cyanotic heart disease or complex cardiac syndromes.
Main Results:
- The prevalence of diagnosed VSDs increased from 1.0 per 1,000 live births in 1970 to 4.0 per 1,000 in 1983.
- This observed trend mirrors the national increase reported by the CDC.
- The study focused on isolated VSDs, excluding complex cardiac conditions.
Conclusions:
- The prevalence of isolated ventricular septal defects (VSD) in infants has significantly increased.
- The study provides objective data on VSD trends in a specific population.
- Further research is needed to understand the underlying causes of the rising VSD prevalence.
Abstract:
A marked increase or "epidemic" in ventricular septal defects (VSD) in recent years has been reported by the Center for Disease Control. Many pediatric cardiologists believe that this increase is simply a reflection of more intensive diagnosis and evaluation of infants throughout the country. Yet to our knowledge there has been no objective evidence for this explanation. We evaluated this possibility by considering records on live births occurring in 1970-1983 in the counties surrounding Albany, New York. In that period a single group of pediatric cardiologists has been evaluating all infants with suspected or confirmed cardiac defects in this area. We limited this analysis to ventricular septal defects unassociated with any cardiac syndrome complex. Thus, VSDs occurring as part of cyanotic heart disease or other complex cardiac "syndromes" were excluded. Consistent with the reported national trend, the estimated prevalence rate of ventricular septal defects diagnosed under 1 year of age in this period has increased from 1.0 per 1,000 live births in 1970 to 4.0 per 1,000 in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)