Global prevalence of congenital heart disease in school-age children: a meta-analysis and systematic review.
Global prevalence of congenital heart disease in school-age children: a meta-analysis and systematic review.
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DOI：
10.1186/s12872-020-01781-x
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发表时间：
2020-11-19
影响因子：
2.1
通讯作者：
Keavney BD
中科院分区：
文献类型：
--
作者：
Liu Y;Chen S;Zühlke L;Babu-Narayan SV;Black GC;Choy MK;Li N;Keavney BD
先天性心脏病（CHD）是最常见的出生缺陷。因此，估计学龄儿童冠心病患病率的研究可能有助于量化诊断和治疗方面未得到满足的卫生需求，特别是在低收入国家。学龄儿童的数据相对较少，个别研究通常规模较小。我们进行了一项基于文献的荟萃分析，以调查40年来的全球趋势。从PubMed、EMBASE、Web of Science和谷歌Scholar检索1970年至2017年学龄儿童（4-18岁）冠心病患病率的研究报告。根据纳入标准，纳入42项研究，包括2,638,475名儿童，报告了未修复的冠心病患病率（包括学龄前诊断和首次学龄期诊断），以及9项研究，包括395,571名儿童，专门报告了首次诊断为学龄期的冠心病患病率。使用随机效应模型合并数据。在整个研究期间，学龄儿童未修复的冠心病患病率为3.809 /1000（95%可信区间为3.075-4.621）。未修复的冠心病学童中，男生的比例低于女生（OR = 0.84 [95% CI 0.74-0.95]; p = 0.001）。在1970-1974年和1995-1999年期间，学龄儿童未修复的冠心病患病率没有显著变化；随后，从1995-1999年的1.985 (95% CI 1.074-3.173)/1000增加到2010-2014年的4.832 (95% CI 3.425-6.480)/1000，增加了约2.5倍（p = 0.009）。在所有冠心病疾病中，房间隔缺损和室间隔缺损占主要增长趋势。1970-2017年儿童期首次诊断冠心病的总患病率为1.384 (0.955,1.891)/1000；在此期间，从1995年前的2.050[1.362,2.877]/1000下降到1995-2014年的0.848 [0.626,1.104]/1000 （p = 0.04）。在全球范围内，这些数据显示，在出生/婴儿期或幼儿期发现的冠心病（主要是轻度冠心病）患病率增加，但在学龄期仍未得到修复。与此同时，学龄儿童首次诊断为冠心病的人数也有所减少。这些共同表明，在生命过程中，冠心病的识别时间向早期转移是有利的。尽管如此，高收入国家和低收入国家之间仍然存在严重的不平等。需要增加对先天性冠心病患者的卫生保健资源，特别是在较贫穷的国家。
Congenital heart disease (CHD) is the commonest birth defect. Studies estimating the prevalence of CHD in school-age children could therefore contribute to quantifying unmet health needs for diagnosis and treatment, particularly in lower-income countries. Data at school age are considerably sparser, and individual studies have generally been of small size. We conducted a literature-based meta-analysis to investigate global trends over a 40-year period. Studies reporting on CHD prevalence in school-age children (4–18 years old) from 1970 to 2017 were identified from PubMed, EMBASE, Web of Science and Google Scholar. According to the inclusion criteria, 42 studies including 2,638,475 children, reporting the prevalence of unrepaired CHDs (both pre-school diagnoses and first-time school-age diagnoses), and nine studies including 395,571 children, specifically reporting the prevalence of CHD first diagnosed at school ages, were included. Data were combined using random-effects models. The prevalence of unrepaired CHD in school children during the entire period of study was 3.809 (95% confidence intervals 3.075–4.621)/1000. A lower proportion of male than female school children had unrepaired CHD (OR = 0.84 [95% CI 0.74–0.95]; p = 0.001). Between 1970–1974 and 1995–1999, there was no significant change in the prevalence of unrepaired CHD at school age; subsequently there was an approximately 2.5-fold increase from 1.985 (95% CI 1.074–3.173)/1000 in 1995–1999 to 4.832 (95% CI 3.425–6.480)/1000 in 2010–2014, (p = 0.009). Among all CHD conditions, atrial septal defects and ventricular septal defects chiefly accounted for this increasing trend. The summarised prevalence (1970–2017) of CHD diagnoses first made in childhood was 1.384 (0.955, 1.891)/1000; during this time there was a fall from 2.050 [1.362, 2.877]/1000 pre-1995 to 0.848 [0.626, 1.104]/1000 in 1995–2014 (p = 0.04). Globally, these data show an increased prevalence of CHD (mainly mild CHD conditions) recognised at birth/infancy or early childhood, but remaining unrepaired at school-age. In parallel there has been a decrease of first-time CHD diagnoses in school-age children. These together imply a favourable shift of CHD recognition time to earlier in the life course. Despite this, substantial inequalities between higher and lower income countries remain. Increased healthcare resources for people born with CHD, particularly in poorer countries, are required.
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DOI：
10.1111/echo.13713
发表时间：
2017-12-01
影响因子：
1.5
作者：
Maulik, Dev;Nanda, Navin C.;Vilchez, Gustavo
通讯作者：
Vilchez, Gustavo
影响因子：
3
作者：
Martin, Seth S.;Shapiro, Edward P.;Mukherjee, Monica
通讯作者：
Mukherjee, Monica
影响因子：
4.3
作者：
Chadha, S. L.;Singh, Neerpal;Shukla, D. K.
通讯作者：
Shukla, D. K.
影响因子：
3.7
作者：
Liu F;Yang YN;Xie X;Li XM;Ma X;Fu ZY;Chen BD;Huang Y;Shan CF;Ma YT;Gao XM
通讯作者：
Gao XM
DOI：
10.1136/bmj.b1673
发表时间：
2009-05-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ionescu-Ittu R;Marelli AJ;Mackie AS;Pilote L
通讯作者：
Pilote L