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Congenital heart disease-related mortality during the first year of life: The peruvian experience
Jose Arriola-Montenegro1, Joel Coronado-Quispe2, Juan Carlos Mego2,3
1Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Insights
Congenital heart disease (CHD) caused 70.6 deaths per 100,000 live births in Peru. Infants in the Andes and those treated by the Ministry of Health (MINSA) faced higher mortality, highlighting the need for a national CHD program.
Area of Science:
- Public Health
- Pediatrics
- Cardiology
Background:
- Congenital heart disease (CHD) is a significant global health concern, affecting approximately 1% of live births.
- Critical CHD (CCHD) necessitates early intervention to prevent neonatal mortality.
- Limited data exists on CHD-related mortality and its determinants in Peru.
Purpose of the Study:
- To analyze CHD-related mortality rates in Peru from 2017 to 2021.
- To identify demographic, geographic, and healthcare-related factors associated with CHD mortality.
- To inform public health strategies for reducing infant mortality due to CHD.
Main Methods:
- Observational secondary analysis of the Peruvian National Computerized System of Deaths (2017-2021).
- Assessment of CHD mortality by sex, age, altitude, region, insurance, healthcare institution, and CHD complexity.
- Geographic visualization using heatmaps, trend analysis via linear regression, and survival analysis with Kaplan-Meier curves.
Main Results:
- Peru reported 70.6 CHD deaths per 100,000 live births.
- Mortality was higher in males, with a median age of death at 1 month.
- Elevated mortality rates were observed in Andean regions (Huancavelica, Junín), at Ministry of Health (MINSA) facilities, and for complex CHDs.
Conclusions:
- Peru faces a critical public health challenge regarding infant mortality from CHD.
- Infants in Andean regions and those receiving care at MINSA facilities are particularly vulnerable.
- Establishing a National Congenital Heart Disease Program is crucial for equitable access to specialized care and saving young lives.
Introduction:
Congenital heart disease (CHD) affects 1 % of all live births globally, with critical CHD (CCHD) requiring early intervention to avoid neonatal mortality. To date, CHD-related mortality within the first year of life and its associated factors have not been studied in Peru.
Methods:
This is an observational secondary analysis using the Peruvian National Computerized System of Deaths, data from 2017 to 2021. CHD-related mortality was assessed by sex, age, altitude level, region, insurance type, healthcare institution, contributing factors, and CHD complexity. Geographic patterns were visualized using heatmaps, trends were analyzed through linear regression and survival analyses were performed using Kaplan Meier curves and log-rank tests.
Results:
Peru experienced 70.6 CHD-related deaths per 100,000 live births. Mortality was significantly higher in males, most CHD-related deaths took place at a median age of 1 month. Regions like Huancavelica and Junín, located in the Andes, exhibited the highest mortality rates. Others significant related factors were receiving care at healthcare institution operated by Ministry of Health (MINSA) and complex CHDs. A non-significant increase in CHD-related deaths and mortality rates was noted, particularly affecting regions such as La Libertad and Lima.
Conclusion:
Peru faces a critical public health crisis concerning CHD-related mortality among infants, especially those living in the Andes and receiving care at healthcare institutions operated by MINSA. A National Congenital Heart Disease Program is essential to ensure equitable access to specialized care, potentially saving numerous young lives.
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