Congenital Heart Defect Case Ascertainment by the Alberta Congenital Anomalies Surveillance System
Congenital Heart Defect Case Ascertainment by the Alberta Congenital Anomalies Surveillance System
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DOI：
10.1002/bdra.23007
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发表时间：
2012-06-01
影响因子：
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通讯作者：
Dyck, John D.
中科院分区：
文献类型：
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作者：
Bedard, Tanya;Lowry, R. Brian;Dyck, John D.
背景：先天性心脏缺陷（CHD）是最常见的先天性畸形类型，有广泛的出生患病率估计报告。本质量保证研究描述了阿尔伯塔先天性异常监测系统（ACASS）对CHD病例的确认。方法：将ACASS的CHD病例数据与其他来源进行比较，包括阿尔伯塔的两个儿科心脏病诊所、阿尔伯塔儿童医院病理科和医院记录。病例包括1995年至2002年在加拿大阿尔伯塔出生的活产、死产和妊娠不足20周的胎儿死亡。在整个研究期间，计算特定类型心脏缺陷病例的出生患病率和卡方线性趋势分析。结果：ACASS对冠心病的诊断符合率为45%。当ACASS作为唯一数据来源时，CHD病例的总患病率为5.59/1000总出生（TB; 95%置信区间[CI]，5.32-5.86），当使用所有数据来源时，CHD病例的总患病率增加至12.42/1000 TB（95% CI，12.03-12.83）。1995年至2002年期间，尽管冠心病病例的总患病率保持稳定，但房间隔缺损（ASD）以及房间隔缺损和室间隔缺损（VSD）的患病率显著增加。在研究期间，左心室流出道梗阻病例的患病率显著降低。结论：儿科心脏病诊所值得纳入作为额外的确定来源，以有助于更准确的患病率估计。ASD和ASD和VSD病例的显著增加可能反映了诊断和确认实践的差异。出生缺陷研究（A部分）94：449-458，2012年。(C)2012 Wiley Periodicals，Inc.
BACKGROUND: Congenital heart defects (CHDs) are the most common type of congenital anomaly, with a wide range of reported birth prevalence estimates. This quality assurance study describes CHD case ascertainment by the Alberta Congenital Anomalies Surveillance System (ACASS). METHODS: ACASS data for CHD cases were compared with additional sources including the two Pediatric Cardiology clinics in Alberta, the Alberta Children's Hospital Department of Pathology, and hospital records. Cases included live births, stillbirths, and fetal deaths at less than 20 weeks' gestation born in Alberta, Canada, between 1995 and 2002. The birth prevalence of cases and chi-square linear trend analyses were calculated for specific types of heart defects for the total study period. RESULTS: The ascertainment of CHD cases by ACASS was 45%. The total prevalence of CHD cases was 5.59 per 1000 total births (TBs; 95% confidence interval [CI], 5.32-5.86) when ACASS was the only data source and increased to 12.42 per 1000 TBs (95% CI, 12.03-12.83) when all data sources were used. Although the total prevalence of CHD cases remained stable during 1995 to 2002, the prevalence of atrial septal defect (ASD) and cases with an ASD and ventricular septal defect (VSD) significantly increased. The prevalence of left ventricular outflow tract obstruction cases significantly decreased during the study period. CONCLUSIONS: Pediatric cardiology clinics are worth including as additional ascertainment sources to contribute to more accurate prevalence estimates. The significant increases of ASD and cases with both an ASD and VSD may reflect differences in diagnostic and ascertainment practices. Birth Defects Research (Part A) 94:449-458, 2012. (C) 2012 Wiley Periodicals, Inc.