Abstract 10809: Temporal Variation in Incidence of Congenital Heart Disease in the United States
Introduction and Hypothesis: Published epidemiologic studies and meta-analysis suggest temporal variation in incidence of congenital heart disease (CHD). These studies do not adjust for confounding factors such as differences in demographics of the study population, study era, and study design. We present a single longitudinal analysis of the largest and most comprehensive database of hospital data in the USA that establishes time trends of the incidence of CHD diagnosis, adjusting for potentially confounding factors.
Methods: We compared all entries of CHD diagnoses in the Nationwide Inpatient Sample (NIS) database in 1998 and 2008 to determine differences in overall and lesion-specific incidence of CHD stratified by race, gender, socioeconomic status and geographical location.
Results: Overall CHD incidence was 10.2/1,000 in 1998 and 10.8/1,000 in 2008. CHD incidence (excluding isolated PDA) decreased from 9.3/1000 in 1998 to 7.9/1, 000 in 2008 (p< 0.05). Diagnosis of isolated PDA increased from 87 to 289 per 100,000 (p< 0.01) while incidence of severe cardiac lesions decreased from 13.1% in 1998 to 8.3% in 2008 (p<0.05). Both populations showed identical pattern of distribution by gender, race, and socioeconomic status.
Conclusions: Our study demonstrated significant increase in incidence of isolated PDA and decrease in incidence of severe cardiac defects while incidence of overall CHD remained unchanged. Increased incidence of PDA diagnosis is most likely due to improved sensitivity and availability of echocardiography while decreased incidence of severe CHD could be due to the impact of improved prenatal diagnosis and decision not to continue the pregnancy.
- © 2013 by American Heart Association, Inc.