Botto L D, Correa A, Erickson J D
Birth Defects and Genetic Diseases Branch, Division of Birth Defects and Developmental Disabilities, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Pediatrics. 2001 Mar;107(3):E32. doi: 10.1542/peds.107.3.e32.
Documenting the prevalence and trends of congenital heart defects provides useful data for pediatric practice, health-care planning, and causal research. Yet, most population-based studies use data from the 1970s and 1980s. We sought to extend into more recent years the study of temporal and racial variations of heart defects occurrence in a well-defined population.
We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based registry with active case ascertainment from multiple sources. Heart defects were identified among liveborn infants up to 1 year old, among stillborn infants, and among pregnancy terminations to mothers residing in metropolitan Atlanta.
From 1968 through 1997, the registry ascertained 5813 major congenital heart defects among 937 195 infants, for a prevalence of 6.2 per 1000. The prevalence increased to 9.0 per 1000 births in 1995 through 1997. The prevalence of ventricular septal defects, tetralogy of Fallot, atrioventricular septal defects, and pulmonary stenosis increased, whereas that of transposition of the great arteries decreased. For some defects, prevalence and trends varied by race.
The prevalence of congenital heart defects is increasing. Whereas most findings likely result from improved case ascertainment and reporting, others might be because of changes in the distribution of risk factors in the population. The basis of the racial variations is incompletely understood.
记录先天性心脏缺陷的患病率和趋势可为儿科实践、医疗保健规划及病因研究提供有用数据。然而，大多数基于人群的研究使用的是20世纪70年代和80年代的数据。我们试图将对明确人群中心脏缺陷发生的时间和种族差异的研究扩展到更近的年份。
我们使用了来自大亚特兰大先天性缺陷项目的数据，这是一个基于人群的登记处，通过多种来源积极确定病例。在大亚特兰大居住的母亲所生的1岁及以下活产婴儿、死产婴儿和终止妊娠中确定心脏缺陷。
从1968年到1997年，该登记处确定了937195名婴儿中有5813例主要先天性心脏缺陷，患病率为每1000例中有6.2例。1995年至1997年，患病率增至每1000例出生中有9.0例。室间隔缺损、法洛四联症、房室间隔缺损和肺动脉狭窄的患病率增加，而大动脉转位的患病率下降。对于某些缺陷，患病率和趋势因种族而异。
先天性心脏缺陷的患病率正在上升。虽然大多数结果可能是由于病例确定和报告的改善，但其他结果可能是由于人群中危险因素分布的变化。种族差异的基础尚未完全了解。
