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Distribution of congenital heart malformations in an autopsied child population
Insights
Congenital heart malformations were found in 6.2% of all autopsied children, with ventricular septal defect being the most common. These defects significantly contributed to overall mortality in liveborn children.
Area of Science:
- Pediatric Pathology
- Cardiology
- Public Health
Background:
- Congenital heart malformations (CHMs) are a significant cause of infant mortality.
- Understanding the prevalence and types of CHMs is crucial for public health initiatives.
Purpose of the Study:
- To determine the prevalence and patterns of congenital heart malformations in stillborn and deceased children.
- To analyze the types and frequency of specific heart lesions and their distribution.
Main Methods:
- Autopsy data from stillborn and deceased children over a 27-year period were analyzed.
- A total of 3969 stillborn and 470,188 liveborn children were included.
- Heart malformations were classified into 37 categories.
Main Results:
- CHMs were identified in 2.1% of stillborn and 0.21% of liveborn children.
- Overall, CHMs were found in 6.2% of all autopsied children, accounting for 7.4% of liveborn mortality.
- Ventricular septal defect was the most common malformation, followed by hypoplastic left ventricle and complete transposition.
Conclusions:
- Congenital heart malformations represent a substantial burden of disease in deceased children.
- Differences in malformation frequency and sex distribution exist between stillborn and liveborn infants.
- Ventricular septal defect is a leading cause of congenital heart disease in this population.
Abstract:
All stillborn and all deceased children were autopsied during a 27-year period in a given territory with some 1,220,000 inhabitants. Of the 3969 stillborn children, 81 (2.1%) had a congenital heart malformation. Out of the 470,188 liveborn children, 13,629 died before the age of 15 years. Autopsy demonstrated a heart malformation in 1008 (0.21%) of these liveborn children. Thus, with 1089 cases found in the combined stillborn and liveborn and later deceased children, congenital heart malformation was found in 6.2% of all autopsied children. This represented 7.4% of the total mortality of liveborn children and 41.4% of all congenital malformation discovered in the deceased children. In total, 2257 congenital heart lesions were identified with a mean of 2.1 lesions per child. The lesions were classified in 37 categories of heart malformation. The most common malformation was ventricular septal defect, followed by hypoplastic left ventricle and complete transposition. The most frequent heart lesion was also ventricular septal defect followed by patency of the arterial duct. The frequency of the different heart malformations in stillborns differed from that in the liveborn children. The ratio of boys and girls in the overall series was 1.28:1, with pronounced differences in sex distribution being observed in some malformations.