Grabitz R G, Joffres M R, Collins-Nakai R L
Heritage Pediatric Cardiology Program, University of Alberta, Edmonton, Canada.
Am J Epidemiol. 1988 Aug;128(2):381-8. doi: 10.1093/oxfordjournals.aje.a114978.
The Heritage Pediatric Cardiology Program is a regional study of patients with congenital heart disease in northern and central Alberta, Canada. Cases of congenital heart disease were confirmed by clinical examination by a pediatric cardiologist plus echocardiography (noninvasive criteria) with or without cardiac catheterization, cardiac surgery, or autopsy (invasive criteria). From 1981 to 1984 inclusive, 573 confirmed cases of congenital heart disease occurred in a population of 103,411 livebirths (5.54 and 3.36/1,000 livebirths using the noninvasive and the invasive criteria, respectively). This is significantly higher (p less than 0.0001) than the rates found in the Baltimore-Washington Infant Study (3.69 and 2.38/1,000 livebirths for the noninvasive and invasive methods, respectively) or the New England Regional Infant Cardiac Program (2.20/1,000 livebirths using invasive methods). Although some lesions occur at rates similar to those found in these other registries, there are 4.4 times more double outlet right ventricles and 2.9 times more atrial septal defects in northern and central Alberta than were found in the New England Regional Infant Cardiac Program (p less than 0.001). The overall congenital heart disease rate has increased 47% between 1981 and 1984, and the rate of ventricular septal defects has doubled during the same period in northern and central Alberta. No methodological bias was found to explain these higher and increasing rates.
传统儿科心脏病学项目是一项针对加拿大艾伯塔省北部和中部先天性心脏病患者的区域性研究。先天性心脏病病例通过儿科心脏病专家的临床检查以及超声心动图（非侵入性标准）确诊，必要时结合心导管检查、心脏手术或尸检（侵入性标准）。在1981年至1984年（含）期间，103,411例活产婴儿中出现了573例确诊的先天性心脏病病例（分别采用非侵入性和侵入性标准时，发病率为每1000例活产婴儿中有5.54例和3.36例）。这一发病率显著高于巴尔的摩 - 华盛顿婴儿研究（分别采用非侵入性和侵入性方法时，发病率为每1000例活产婴儿中有3.69例和2.38例）或新英格兰地区婴儿心脏项目（采用侵入性方法时发病率为每1000例活产婴儿中有2.20例）（p值小于0.0001）。尽管某些病变的发病率与其他登记处相似，但艾伯塔省北部和中部的右心室双出口病例数是新英格兰地区婴儿心脏项目的4.4倍，房间隔缺损病例数是其2.9倍（p值小于0.001）。1981年至1984年间，先天性心脏病总体发病率上升了47%，艾伯塔省北部和中部的室间隔缺损发病率在此期间翻了一番。未发现方法学偏差可以解释这些较高且不断上升的发病率。
