Egbe Alexander, Uppu Santosh, Stroustrup Annemarie, Lee Simon, Ho Deborah, Srivastava Shubhika
Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1201, New York, NY, 10029, USA,
Pediatr Cardiol. 2014 Aug;35(6):975-82. doi: 10.1007/s00246-014-0884-8. Epub 2014 Feb 22.
Current estimates of the incidence of congenital heart disease (CHD) are derived from small clinical studies and metaanalyses. For the true incidence of CHD in the United States of America to be estimated, a single large representative population must be analyzed. All the data in this study were derived from the Nationwide Inpatient Sample database. The study determined the overall and lesion-specific incidences of CHD diagnoses among all birth hospitalizations in 2008, stratified by race, gender, socioeconomic status, and hospital geographic location. The study identified 13,093 CHD diagnoses among 1,204,887 birth hospitalizations, yielding an incidence of 10.8 per 1,000, with a predominance of mild lesions and septal defects. Atrial septal defect (ASD) and pulmonic stenosis were more common among females, whereas aortic stenosis, coarctation of the aorta, hypoplastic left heart syndrome, and d-transposition of great arteries were more common among males. No racial difference was observed in the overall CHD incidence. However, isolated patent ductus arteriosus (PDA) and ventricular septal defects (VSDs) were more common among Caucasians, whereas ASDs were more common among Hispanics. The incidences of CHD diagnoses were similar for all socioeconomic classes except the lowest socioeconomic class, which had a significantly lower CHD incidence. There was no geographic or seasonal variation in CHD incidence. This study demonstrated the incidence of echocardiographically confirmed CHD diagnosis to be 10.8 per 1,000 live births, marked by a high proportion of mild cardiac lesions and isolated PDAs. The high incidence of isolated PDAs in this study may be explained by the inclusion of only CHD diagnoses during birth hospitalization.
目前对先天性心脏病(CHD)发病率的估计来自小型临床研究和荟萃分析。为了估计美国CHD的真实发病率,必须分析一个具有代表性的单一大型人群。本研究中的所有数据均来自全国住院患者样本数据库。该研究确定了2008年所有出生住院病例中CHD诊断的总体发病率和特定病变发病率,并按种族、性别、社会经济地位和医院地理位置进行分层。该研究在1,204,887例出生住院病例中确定了13,093例CHD诊断,发病率为每1000例中有10.8例,以轻度病变和间隔缺损为主。房间隔缺损(ASD)和肺动脉狭窄在女性中更为常见,而主动脉狭窄、主动脉缩窄、左心发育不全综合征和大动脉d型转位在男性中更为常见。在总体CHD发病率上未观察到种族差异。然而,孤立性动脉导管未闭(PDA)和室间隔缺损(VSD)在白种人中更为常见,而ASD在西班牙裔中更为常见。除了社会经济地位最低的阶层CHD发病率显著较低外,所有社会经济阶层的CHD诊断发病率相似。CHD发病率没有地理或季节变化。本研究表明,经超声心动图确诊的CHD诊断发病率为每1000例活产中有10.8例,其特点是轻度心脏病变和孤立性PDA的比例较高。本研究中孤立性PDA的高发病率可能是由于仅纳入了出生住院期间的CHD诊断。