RT Journal Article
SR Electronic
T1 Prevalence, timing of diagnosis and mortality of newborns with congenital heart defects: a population-based study
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1667
OP 1673
DO 10.1136/heartjnl-2012-302543
VO 98
IS 22
A1 Babak Khoshnood
A1 Nathalie Lelong
A1 Lucile Houyel
A1 Anne-Claire Thieulin
A1 Jean-Marie Jouannic
A1 Suzel Magnier
A1 Anne-Lise Delezoide
A1 Jean-François Magny
A1 Caroline Rambaud
A1 Damien Bonnet
A1 François Goffinet
A1 on behalf of the EPICARD Study Group
YR 2012
UL http://heart.bmj.com/content/98/22/1667.abstract
AB Objective To assess the prevalence, timing of diagnosis and infant mortality of congenital heart defects (CHD) with population-based data and using a classification that allows regrouping of the International Paediatric and Congenital Cardiac Code into a manageable number of categories based on anatomic and clinical criteria (ACC-CHD). Design Population-based cohort study. Setting Greater Paris. Patients All cases (live births, terminations of pregnancy for foetal anomaly (TOPFA), foetal deaths) diagnosed prenatally, or up to 1 year of age in the birth cohorts, May 2005–April 2008, for women in Greater Paris (n=317 538 births). Diagnoses were confirmed in specialised centres and subsequently coded and classified into the categories of ACC-CHD by paediatric cardiologists in the study group. Results The total number of CHD was 2867, including 2348 live births (82%), 466 TOPFA (16.2%) and 53 foetal deaths (1.8%). The total prevalence of CHD was 90 per 10 000. After exclusion of ventricular septal defects (VSD), 40% of ‘isolated’ CHD was diagnosed prenatally with about one half of the remaining diagnosed before 7 days of age. Nevertheless, one in five cases of these major CHD was diagnosed after the fourth week. Infant mortality of ‘isolated’ CHD-VSD excluded was 8.5% with 40% of deaths occurring after the fourth week of life. These outcomes varied substantially across categories of ACC-CHD. Conclusions Timing of diagnosis, TOPFA, risk and timing of infant mortality were highly variable across the categories of CHD in ACC-CHD, suggesting that it may be a useful measure of severity, and hence, predictor of outcomes of CHD.