Jortveit Jarle, Øyen Nina, Leirgul Elisabeth, Fomina Tatiana, Tell Grethe S, Vollset Stein Emil, Eskedal Leif, Døhlen Gaute, Birkeland Sigurd, Holmstrøm Henrik
Department of Cardiology, Sørlandet Hospital, Arendal, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Congenit Heart Dis. 2016 Mar-Apr;11(2):160-8. doi: 10.1111/chd.12307. Epub 2015 Nov 11.
The aim of the present nationwide cohort study was to describe trends in 1-year mortality in live-born children with congenital heart defects in Norway 1994-2009 and to assess whether changes in the proportion of terminated pregnancies and altered operative mortality have influenced these trends.
Medical information concerning all 954 413 live births, stillbirths, and late-term abortions in Norway, 1994-2009, was retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry for Congenital Heart Defects and the Norwegian Cause of Death Registry. Survivors were followed through 2012.
The 1-year cumulative mortality proportion during the study period was 17.4% for children with severe congenital heart defects and 3.0% for children with nonsevere congenital heart defects. The 1-year cumulative mortality proportion among live born children with severe congenital heart defects decreased 3.6% (95% CI: -5.4, -1.5) per year. The total mortality of severe congenital heart defects was unchanged when including stillbirths and late-term abortions with severe congenital heart defects. The proportion of stillbirths or terminated pregnancies with severe congenital heart defects among all pregnancies with severe congenital heart defects, was on average 8.8% over the entire period with an annually increase of 16.6% (11.4, 18.0). The mean operative mortality in children with severe congenital heart defects was 8.4% and decreased by 9.0% (-11.9, -5.9) per year.
The 1-year mortality of severe congenital heart defects among live births, 1994-2009, declined in Norway. The downward trend in mortality may be explained by a more frequent use of termination of affected pregnancies, and the reduced operative mortality of severe congenital heart defects.
本全国性队列研究旨在描述1994 - 2009年挪威先天性心脏病活产儿的1年死亡率趋势，并评估终止妊娠比例的变化和手术死亡率的改变是否影响了这些趋势。
从挪威医疗出生登记处、挪威心血管疾病项目、奥斯陆大学医院先天性心脏病临床登记处以及挪威死亡原因登记处获取了1994 - 2009年挪威所有954413例活产、死产和晚期流产的医疗信息。对幸存者随访至2012年。
研究期间，患有严重先天性心脏病的儿童1年累积死亡率为17.4%，患有非严重先天性心脏病的儿童为3.0%。患有严重先天性心脏病的活产儿1年累积死亡率每年下降3.6%（95%可信区间：-5.4，-1.5）。纳入患有严重先天性心脏病的死产和晚期流产时，严重先天性心脏病的总死亡率不变。在所有患有严重先天性心脏病的妊娠中，患有严重先天性心脏病的死产或终止妊娠的比例在整个期间平均为8.8%，每年增加16.6%（11.4，18.0）。患有严重先天性心脏病儿童的平均手术死亡率为8.4%，每年下降9.0%（-11.9，-5.9）。
1994 - 2009年挪威活产儿中严重先天性心脏病的1年死亡率下降。死亡率的下降趋势可能是由于受影响妊娠终止的使用更为频繁，以及严重先天性心脏病手术死亡率的降低。
