Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening
Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening
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DOI：
10.1111/apa.12170
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发表时间：
2013-04-01
期刊：
影响因子：
3.8
通讯作者：
Huang, Guo-ying
中科院分区：
文献类型：
--
作者：
Zhao, Qu-ming;Ma, Xiao-jing;Huang, Guo-ying
目的 使用超声心动图筛查确定活产时先天性心脏病 (CHD) 的真实患病率。方法连续纳入2所二级医院新生儿5190例。每个新生儿平均在 47 小时时接受了完整的临床评估和超声心动图诊断。对患有持续性CHD的新生儿进行至少4个月的随访，并评估轻度CHD患病率的时间趋势。结果 活产儿冠心病总患病率为26.6%（重度3.5%，中度5.4%，轻度17.7%），临床评估可检出的冠心病患病率为12.1%。最常见的CHD是室间隔缺损（VSD，千分之17.3），其次是房间隔缺损（ASD，千分之6.2）、动脉导管未闭（PDA，千分之1.3）、法洛四联症（TOF，千分之0.4）、单心室（SV，千分之0.4）、房室间隔缺损（AVSD，千分之0.2）千）和双出口右心室（DORV，千分之 0.2）。轻度CHD（VSD、ASD）以女性为主，重度CHD以男性为主。 4个月随访时，CHD患病率降至千分之19.5，这主要是由于肌肉VSD自发闭合率所致。结论 通过超声心动图筛查确定的先天性心脏病患病率高于出生缺陷登记处的患病率，但更准确。
Aim To determine the true prevalence of congenital heart disease (CHD) at live birth using echocardiographic screening. Methods A total of 5190 consecutive newborns from two secondary hospitals were included. Each neonate had a complete clinical evaluation with echocardiographic diagnosis at average 47h of age. Newborns with persistent CHD underwent at least 4months of follow-up, and the temporal trend of prevalence of mild CHD was assessed. Results Overall live birth prevalence of CHD was 26.6 parts per thousand (severe 3.5 parts per thousand, moderate 5.4 parts per thousand and mild 17.7 parts per thousand), and prevalence of CHD that could be detected by clinical evaluation was 12.1 parts per thousand. The most common CHD was ventricular septal defect (VSD, 17.3 parts per thousand), followed by atrial septal defect (ASD, 6.2 parts per thousand), patent ductus arteriosus (PDA, 1.3 parts per thousand), tetralogy of Fallot (TOF, 0.4 parts per thousand), single ventricle (SV, 0.4 parts per thousand), atrioventricular septal defect (AVSD, 0.2 parts per thousand) and double outlet right ventricle (DORV, 0.2 parts per thousand). Female predominance was observed in mild CHD (VSD, ASD), and male predominance was observed in severe CHD. The prevalence of CHD was reduced to 19.5 parts per thousand at the 4-month follow-up, which was largely caused by spontaneous closure rate of muscular VSD. Conclusion Prevalence of CHD determined by echocardiography screening was higher but more accurate than that obtained from birth defect registries.