Epidemiology of congenital heart disease in the United States
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1Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782.
Insights
Congenital heart disease (CHD) significantly impacts the US, causing thousands of deaths and hospitalizations annually. While infant mortality rates for some CHDs declined due to improved care, others, like hypoplastic left heart syndrome, saw increases.
Area of Science:
- Cardiology
- Public Health
- Pediatrics
Background:
- Congenital heart disease (CHD) represents a significant public health concern in the United States.
- Previous data indicated substantial mortality and morbidity associated with CHD and other congenital circulatory anomalies.
Purpose of the Study:
- To assess the overall burden of congenital heart disease in the United States using national health statistics.
- To analyze trends in mortality, hospitalizations, and treatment for CHD.
Main Methods:
- Analysis of data from the National Center for Health Statistics.
- Examination of mortality records, hospital discharge data, and birth certificate information.
Main Results:
- Between 1979-1988, 46,450 deaths were attributed to CHD, with over half in infants.
- Over 300,000 hospital discharges involved CHD diagnoses (1988-1990), with infants having a high incidence rate.
- Infant mortality rates for some treatable CHDs declined, but rates for hypoplastic left heart syndrome increased.
Conclusions:
- Improvements in surgical techniques and intensive care likely contributed to declining infant mortality for certain CHDs.
- Higher infant mortality rates in nonmetropolitan areas suggest potential disparities in healthcare access.
- Ongoing monitoring and targeted interventions are crucial for managing the burden of congenital heart disease.
Abstract:
Data from the National Center for Health Statistics were examined to aid in assessing the burden of congenital heart disease in the United States. In 1979 through 1988 combined, 46,450 deaths were attributed to CHD, 26,319 occurring in the first year of life. Another 14,283 deaths were attributed to other congenital anomalies of the circulatory system. In 1988 through 1990 combined, there were > 300,000 hospital discharges with any diagnosis of CHD, with 2.7 million days of care provided. For infants aged < 1 year, the rate was 13.7 per 1000 live births per year. Another 242,049 discharges had any diagnosis of other congenital circulatory anomalies. In 1983 through 1985, > 700,000 persons reported a history of CHD. In 1989, heart malformations were reported on the birth certificate of 4621 live births in 45 states and the District of Columbia. In 1988 through 1990 there were an estimated 37,445 repairs of atrial and ventricular septa. In addition, 45,635 cardiac catheterizations were performed in patients aged < 5. Average annual percentage declines in infant mortality rates for the period 1979 through 1988 were consistent with an effect of improvements in surgical technique and intensive care. The average annual infant mortality rate for hypoplastic left heart syndrome increased 1.3%, and rates for five causes amenable to treatment such as transposition of great vessels declined. Infant mortality rates in nonmetropolitan areas were higher than in metropolitan areas, suggesting that limited access to care might be associated with mortality.(ABSTRACT TRUNCATED AT 250 WORDS)