Prevalence and Mortality of congenital heart defects in Tuscany Region: a population based study
Year: 2012
Type: conference-abstract
Study design: Observational Study
Abstract: Prevalence and mortality of congenital heart defects in Tuscany: a population based study. Baldacci S, Pierini A., Santoro M., Spadoni I., Bianchi F. Background-Congenital heart defects (CHDs) are the most frequent group of congenital anomalies and the main cause of mortality in newborns. Estimation of the prevalence of CHDs according their severity is crucial to plan health care services and to set up specific preventive actions. Objective-The aim of the study is to estimate the prevalence and mortality of All CHDs and Nonchromosomal CHDs (NCHRCHD), in Tuscany from 1992 to 2009, and to compare two sub-periods. Methods-Data collected by the population-based EUROCAT Registry of Birth Defects of Tuscany, were used. They regarded live births (LBs), fetal deaths (FDs), terminations of pregnancy for fetal anomaly (TOPFA), prenatal diagnosis (PD), perinatal and neonatal mortality, out of 488,890 births surveyed from 1992 to 2009. All cases were coded according to the ICD9-BPA or ICD-10. The NCHRCHD cases were classified in three severity classes: SI, SII, SIII (according to decreasing perinatal mortality). The NCHRCHD cases were classified into isolated or associated according to the presence or absence of an additional major non-cardiac anomaly. Results-3,653 CHD cases were identified for an overall prevalence of 7.47 per 1,000. LBs prevalence decreased significantly from 1992-2000 to 2001-2009 (Rate Ratio, RR=0.81 95%CI:0.76-0.87), while TOPFA prevalence increased more than 2-fold (RR=2.56 95%CI:1.80-3.71). The rate of perinatal and neonatal mortality significantly reduced (RR=0.38 95%CI:0.23-0.60; RR=0.34 95%CI:0.22-0.51). The PD cases increased more than 2-fold (RR=2.13 95% CI:1.75-2.61). 3,465 NCHRCHD cases were ascertained with a prevalence of 7.09 per 1000. The LBs prevalence decreased significantly (RR=0.82 95%CI:0.77-0.88). TOPFA prevalence increased by almost 3-fold (RR= 2.63 95%CI:1.75-4.05), PD cases doubled (RR=2.29 95%CI: 1.84-2.88). Neonatal mortality was slightly lower than the perinatal (RR=0.29 95%CI:0.18-0.46; RR=0.37 95%CI: 0.22- 0.61). SI and SII CHDs combined were approximately a quarter (N=765; 22.1%) of the total cases, with a stable total prevalence over time (RR=0.98 95%CI:0.84-1.13) and a 17% significantly decreasing of LBs prevalence. LBs with CHDs (more than 90% isolated) were 72% in SI, 92% in SII, 99% in SIII. Overall, more than 90% of TOPFA occurred in SI and SII classes. Only 10% of TOPFA cases had an associated anomaly in SI, almost 50% in SII. Conclusion-This study provides the measure of the prevalence of the CHDs in Tuscany. These estimates can be used to evaluate variations across population over time. Notwithstanding the decreasing of LBs prevalence of more severe CHDs, their impact remains relevant and interventions strategies should be take it into account.
Authors: Baldacci, Silvia, Pierini, Anna, Santoro, Michele, Spadoni, Isabella, Bianchi, Fabrizio
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6986465032