Open Access

ARTICLE

The birth prevalence, severity, and temporal trends of congenital heart disease in the middle‐income country: A population‐based study

Mohd Nizam Mat Bah¹, Mohd Hanafi Sapian¹, Mohammad Tamim Jamil¹, Nisah Abdullah¹, Emieliyuza Yusnita Alias¹, Norazah Zahari²

1 Department of Pediatrics, Hospital Sultanah Aminah Johor Bahru, Ministry of Health Malaysia, Johor, Malaysia
2 Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

* Corresponding Author: Mohd Nizam MAT BAH, Consultant Pediatrician and Pediatric Cardiologist, Pediatric Department, Hospital Sultanah Aminah Johor Bahru, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor DT, Malaysia. Email:

Congenital Heart Disease 2018, 13(6), 1012-1027. https://doi.org/10.1111/chd.12672

Abstract

Objectives: There is limited data on congenital heart disease (CHD) from the lower‐ and middle‐income country. We aim to study the epidemiology of CHD with the specific objective to estimate the birth prevalence, severity, and its trend over time.
Design: A population‐based study with data retrieved from the Pediatric Cardiology Clinical Information System, a clinical registry of acquired and congenital heart dis‐ ease for children.
Setting: State of Johor, Malaysia.
Patients: All children (0‐12 years of age) born in the state of Johor between January 2006 and December 2015.
Intervention: None.
Outcome measure: The birth prevalence, severity, and temporal trend over time.
Results: There were 531 ,904 live births during the study period with 3557 new cases of CHD detected. Therefore, the birth prevalence of CHD was 6.7 per 1000 live births (LB) (95% confidence interval [CI]: 6.5‐6.9). Of these, 38% were severe, 15% moderate, and 47% mild lesions. Hence, the birth prevalence of mild, moderate, and severe CHD was 3.2 (95% CI: 3.0‐3.3), 0.9 (95% CI: 0.9‐ 1.1), and 2.6 (95% CI: 2.4‐2.7) per 1000 LB, respectively. There was a significant increase in the birth prevalence of CHD, from 5.1/1000 LB in 2006 to 7.8/1000 LB in 2015 (P < .0001) due to increase in detection of both mild (1.9/1000 LB in 2006 to 3.9/1000 LB in 2015, P < .001) and severe CHD (1.8/1000 LB in 2005 to 2.9/1000 LB in 2015, P < .001).
Conclusions: The birth prevalence of CHD was 6.7 per 1000 live births, and two in five were severe and significantly associated with syndrome and extracardiac defect. There was a significant increase in the detection of severe lesions in recent years leading to more burden to resources that are already limited in the middle‐income country. Therefore, strategic and comprehensive pediatric and congenital heart sur‐ gery program is required.

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Keywords

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