Open Access

ARTICLE

Atrial Septal Defect in Children: The Incidence and Risk Factors for Diagnosis

Gustaf Tanghöj^1,*, Anna Lindam², Petru Liuba^3,4, Gunnar Sjöberg⁵, Estelle Naumburg¹

1 Department of Clinical Sciences, Unit of Pediatrics, Umeå University, Umeå, Sweden
2 Department of Public Health and Clinical Medicine, Unit of Research, Education and Development Östersund Hospital, Umeå University, Umeå, Sweden
3 Department of Pediatric Cardiology, Skåne University Hospital, Lund, Sweden
4 Department of Clinical Sciences, Lund University, Lund, Sweden
5 Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden

* Corresponding Author: Gustaf Tanghöj. Email:

Congenital Heart Disease 2020, 15(5), 287-299. https://doi.org/10.32604/CHD.2020.011977

Received 09 June 2020; Accepted 14 August 2020; Issue published 23 September 2020

Abstract

Objective: Secundum atrial septal defect (ASD II) is a common congenital heart defect, and interatrial communications among preterm children is even more common. The objective of this study was to calculate the incidence of ASD II in children, with assessment to gestational age at birth. Further, to assess maternal, prenatal and postnatal risk factors associated with ASD II among children of different gestational age at birth. Design: This national registry based retrospective incidence study was supplemented with a national case-control study, using the Swedish Register of Congenial Heart Disease, Swedish Medical Birth Register and Statistics Sweden. All children, 0–18 years of age, born in Sweden and diagnosed with an ASD II between 2010 and 2015 were included in the study and compared with children without diagnosis of ASD II. Results: The yearly overall incidence of ASD II was 150 per 100 000 live births. However, this incidence ranged from 449 per 100 000 live births to 1737 per 100 000 live births, with higher incidence among preterm children. ASD II was associated with a presence of persistent ductus arteriosus; OR = 8.11 (Cl 95% 2.80–16.69), female gender; OR = 1.39 (Cl 95% 1.18–1.63) and being small for gestational age; OR = 1.86 (Cl 95% 1.29–2.68). Born preterm was also associated with ASD II; born at 32–36 gestational children; OR = 3.21 (Cl 95% 2.46–4.19), and born <32 gestational weeks; OR = 4.02 (Cl 95% 2.80–7.12). Conclusion: Preterm children have a higher incidence of ASD II than previously found, increasing with lower gestational age at birth. Preterm birth is an independent risk factor for ASD II diagnosis with three to four times, suggesting that this group of children may need new structured follow up program with careful assessment of indication when need of treatment and closure.

---

Keywords

---