Wu Weiliang, He Jinxian, Shao Xiaobo
Department of Orthopedic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou.
Department of Cardiovascular and Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
Medicine (Baltimore). 2020 Jun 5;99(23):e20593. doi: 10.1097/MD.0000000000020593.
Congenital heart disease (CHD) is the most commonly diagnosed congenital disorder in newborns. The incidence and mortality of CHD vary worldwide. A detailed understanding of the global, regional, and national distribution of CHD is critical for CHD prevention.We collected the incidence and mortality data of CHD from the Global Burden of Disease study 2017 database. Average annual percentage change was applied to quantify the temporal trends of CHD incidence and mortality at the global, regional, and national level, 1990-2017. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.The incidence of CHD was relatively high in developing countries located in Africa and Asia, while low in most developed countries. Between 1990 and 2017, the CHD incidence rate remained stable at the global level, whereas increased in certain developed countries, such as Germany and France. The age-standardized mortality rate of CHD declined substantially over the last 3 decades, regardless of sex, age, and SDI region. The decline was more prominent in developed countries. We also detected a significant positive correlation between CHD incidence and CHD mortality in both 1990 and 2017, by SDI.The incidence of CHD remained stable over the last 3 decades, suggesting little improvement in CHD prevention strategies and highlighting the importance of etiological studies. The mortality of CHD decreased worldwide, albeit the greatly geographical heterogeneity. Developing countries located in Africa and Asia deserve more attention and priority in the global CHD prevention program.
先天性心脏病（CHD）是新生儿中最常被诊断出的先天性疾病。CHD的发病率和死亡率在全球范围内各不相同。详细了解CHD在全球、区域和国家层面的分布情况对于CHD的预防至关重要。我们从《2017年全球疾病负担研究》数据库中收集了CHD的发病率和死亡率数据。采用年均百分比变化来量化1990年至2017年全球、区域和国家层面CHD发病率和死亡率的时间趋势。基于人均收入、教育程度和生育率为每个地区创建了社会人口学指数（SDI）。非洲和亚洲的发展中国家CHD发病率相对较高，而大多数发达国家则较低。1990年至2017年期间，全球层面CHD发病率保持稳定，而在某些发达国家如德国和法国则有所上升。在过去三十年中，无论性别、年龄和SDI区域如何，CHD的年龄标准化死亡率都大幅下降。这种下降在发达国家更为显著。我们还通过SDI发现在1990年和2017年CHD发病率与CHD死亡率之间存在显著的正相关。在过去三十年中CHD发病率保持稳定，这表明CHD预防策略几乎没有改善，并凸显了病因学研究的重要性。尽管存在很大的地理异质性，但全球范围内CHD死亡率有所下降。位于非洲和亚洲的发展中国家在全球CHD预防计划中应得到更多关注和优先考虑。
