先天性心臟病流行病學材料

1、Congenital heart malformation: Prevalence, severity, survival, and quality of life先天性心臟病流行病學The lowest values/1000 live birthsAuthor Region Fyler 2.10 New England, USAGardiner 2.17 Toronto, CanadaAkman 3.20 Bogalusa, USAMacMahon 3.20 Birmingham, UKMckeown 4.20 Birmingham, UKBosi 4.60 ItalyBierman 4.

2、70 HawaiiPrevalence of congenital heart malformation at birththe highest values/ 1000 births author Region Fischer 8.20 Tyrol,AustriaKerrebijn 8.26 Leiden , NetherlandGrech 8.80 MaltaHoffmann 8.82 San Francisco, USAMeberg 9.02 NorwayNakazawa 10.00 JapanManetti 12.30 Florence, ItalyYerushalmi 11.70 C

3、alifornia,USAPrevalence of congenital heart malformation at birthThe oldest surveys/ 1000 live birthsAuthor Date Prevalence () Macmahon 194049 3.23Carlgren 1941 50 6.35Harris 194450 5.90Pleydell 194457 3.20Landtman 1945 63 8.00Richards 194653 5.50Gardiner 194849 2.17Mustachi 194951 5.88Prevalence of

4、 congenital heart malformation at birthRecent data / 1000 live birthsAuthor Date Prevalence() Grech 1990-94 8.80Robida 1984-94 12.23Bosi 1992-93 4.60Anderson 1987-90 10.20Cerboni 1988-90 6.08Ferencz 1981-89 4.23Pexieder 1986-87 6.04Meberg 1982-88 9.02Prevalence of congenital heart malformation at bi

5、rthPrevalence of congenital heart malformation at birthRegional differences/ 1000 live birthsRegion Mean Range difference place Europe 6.67 3.20 Birmingham, UK 12.30 Florence, ItalyUSA 5.76 3.20 Bogalusa 8.56 San FranciscoCanada 3.97 2.17 Toronto 5.54 AlbertaOther countries 8.97 6.08 Guadeloupe Year

6、ly fluctuation in Bohemian data from 1980 through 1989Year No. of malformation Prevalence/ 1000 646 7.04 547 6.39 568 6.771983 548 6.73 566 6.97 495 6.16 436 5.53 455 5.82 402 5.11 367 4.80 Prevalence of congenital heart malformation at birth The prevalence was highest in October, and lowest in Dece

7、mber ,June and July. The peak of the prevalence coincided with the epidemics of influenza in early pregnancy 8 and 9 months previously.There was a definite seasonal variationRatio of boys to girlsBoys to girls with CHD: 51.9% to 48.1%A higher proportion of boys was found with : DORV (2.68: 1); HLHS

8、(2.25 :1) cTGA ( 2.11 :1); A higher proportion of girls was found with:PDA (1 :1.66); Ebsteins malformation (1 :1.57)Common arterial trunk (1:1.22)Distribution of congenital heart malformationVSD 41.59%ASD 8.67%Aortic stenosis 7.77%Pulmonary stenosis 5.81%cTGA 5.39%Aortic coarctation 5.29%PDA 5.07%

9、Greater than 5% of the overall number of malformationDistribution of congenital heart malformation AVSD 4.00% HLHS 3.42% TOF 3.36%DORV, common arterial trunk and pulmonary atresia 1.05-1.37%TAPVC 0.80%Tricuspid 0.78%Ebstein malformation 0.44%Interrupted aortic arch 0.44%Spontaneous closure in 576 of

10、 2092 recognized ventricular Septal defects, accounting for 27.5% of the casesCritical heart malformation in neonates,10 most frequent Number proportion of total Malformations number seen(%)cTGA 102 84Pul atresia 39 74Coarctation 34 49HLHS 34 94Tricuspid atresia 13 77DORV 20 50VSD 8 8Common AT 8 50T

11、OF 7 28Critical heart disease: which threaten life,which manifested by severve Congestive heart failure,deep cyanosis, or both symptomsDeath rate of children born with CHDSurvival in most frequent cardiac malformation CHD Number survival (%) at age of 1 5 15yrsVSD 2097 91 90 89ASD 436 94 93 93Aortic stenosis 391 90 89 88PS 292 96 96 96cTGA 271 62 56 54Coarctation 266 68 65 65PDA 255 91 91 91AVSD 201