Lucron Hugues, Brard Mélanie, d'Orazio Julie, Long Laurence, Lambert Véronique, Zedong-Assountsa Serge, Le Harivel de Gonneville Alix, Ahounkeng Patrick, Tuttle Saskia, Stamatelatou Marianna, Grierson Rory, Inamo Jocelyn, Cuttone Fabio, Elenga Narcisse, Bonnet Damien, Banydeen Rishika
Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France.
Neonatal and Pediatric Department, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France.
Lancet Reg Health Am. 2023 Dec 14;29:100649. doi: 10.1016/j.lana.2023.100649. eCollection 2024 Jan.
Few studies have assessed the prevalence and mortality of simple or complex congenital heart diseases (CHD) in newborns. In Latin America and Caribbean (LAC), CHD epidemiology seems highly variable, with few population-based assessments and different methodologies between studies. To date, the situation in French Guiana, a French overseas territory located in South America between Brazil and Suriname, has never been described.
We analysed CHD prevalence, characteristics and related infant mortality in French Guiana, with a population-based registry analysis of all fetal and live birth CHD cases in infants under 1 year (January 2012-December 2016).
Overall, 33,796 births (32,975 live births) were registered, with 231 CHD (56 fetuses), including 215 live births. Most frequent CHD categories were anomalies of the ventricular outflow tract and extra-pericardial trunks, and ventricular septal defects. 18.6% (43/231) chromosomal or genetic anomalies, and 6.5% (15/231) terminations of pregnancy were observed. Total CHD prevalence was 68.4 [95% CI: 67.9-68.8] per 10,000, while live birth prevalence was 65.2 [95% CI: 64.7-65.7] per 10,000. Total infant mortality was 9.4/10,000 live births [95% CI 9.1-9.7], with highest rates for functionally univentricular hearts (FUH).
A distinct profile for CHD is highlighted in French Guiana with elevated mortality linked to FUH. A potential determinant of the recognized excess mortality risk might be the presence of chromosomal or genetic anomalies in about a fifth of all CHD. This helps us to better understand CHD burden in this part of South America and provides future keys towards reducing CHD-related infant mortality.
The authors received no financial support for the present research, authorship, and/or publication of this article.
很少有研究评估新生儿单纯或复杂先天性心脏病（CHD）的患病率和死亡率。在拉丁美洲和加勒比地区（LAC），CHD的流行病学情况似乎差异很大，基于人群的评估很少，且各研究之间的方法不同。迄今为止，法属圭亚那（位于南美洲巴西和苏里南之间的一个法国海外领地）的情况从未被描述过。
我们通过对法属圭亚那1岁以下婴儿（2012年1月至2016年12月）所有胎儿和活产CHD病例进行基于人群的登记分析，来分析CHD的患病率、特征及相关婴儿死亡率。
总体而言，登记了33,796例出生（32,975例活产），其中有231例CHD（56例胎儿），包括215例活产。最常见的CHD类型是心室流出道和心包外主干异常以及室间隔缺损。观察到18.6%（43/231）为染色体或基因异常，6.5%（15/231）为妊娠终止。CHD总患病率为每10,000例中有68.4例[95%置信区间：67.9 - 68.8]，而活产患病率为每10,000例中有65.2例[95%置信区间：64.7 - 65.7]。婴儿总死亡率为每10,000例活产中有9.4例[95%置信区间9.1 - 9.7]，功能单心室心脏（FUH）的死亡率最高。
法属圭亚那突出显示了CHD的独特特征，死亡率升高与FUH相关。公认的额外死亡风险的一个潜在决定因素可能是所有CHD中约五分之一存在染色体或基因异常。这有助于我们更好地了解南美洲这一地区的CHD负担，并为降低与CHD相关的婴儿死亡率提供未来的关键线索。
作者未获得本研究、作者身份和/或本文发表的任何资金支持。
