Wilson P D, Correa-Villaseñor A, Loffredo C A, Ferencz C
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201.
Epidemiology. 1993 May;4(3):259-65.
We studied the yearly occurrence of isolated cardiovascular malformations in liveborns for the period 1981-1988 in Maryland and the District of Columbia. We used Poisson regression to fit yearly prevalence at birth as a function of time for all cardiovascular malformation case types combined and for three diagnostic subgroups. We give results separately by diagnostic method and race (white/nonwhite), with categories combined when appropriate. Time trends were similar for both races except in pulmonic stenosis diagnosed by echocardiography. The yearly prevalence for all case types, all races, and all diagnostic methods combined increased from 28 to 43 per 10,000 livebirths over the 8 years, due to an increase in the rate among infants diagnosed by echocardiography. For every diagnostic-type-by-race group studied, there were increases in the prevalence for those diagnosed by echocardiography and decreases (or no change in one group) for those diagnosed by cardiac catheterization and/or surgery. Although there may have been an increase in actual occurrence of cardiovascular malformation over our study period, it is also possible that wider use of a new echocardiography technology resulted in increased detection.
我们研究了1981年至1988年期间马里兰州和哥伦比亚特区活产儿中孤立性心血管畸形的年度发生率。我们使用泊松回归来拟合所有心血管畸形病例类型合并以及三个诊断亚组的出生时年度患病率作为时间的函数。我们按诊断方法和种族（白人/非白人）分别给出结果，在适当情况下合并类别。除了通过超声心动图诊断的肺动脉狭窄外，两个种族的时间趋势相似。在这8年中，所有病例类型、所有种族和所有诊断方法合并的年度患病率从每10,000例活产儿中的28例增加到43例，这是由于通过超声心动图诊断的婴儿比例增加所致。对于所研究的每个按诊断类型和种族划分的组，通过超声心动图诊断的患病率有所增加，而通过心导管检查和/或手术诊断的患病率有所下降（或一组无变化）。尽管在我们的研究期间心血管畸形的实际发生率可能有所增加，但也有可能是新超声心动图技术的更广泛应用导致了检测率的提高。
