Current estimates of the incidence of congenital heart disease (CHD) are derived from small clinical studies and metaanalyses. For the true incidence of CHD in the United States of America to be estimated, a single large representative population must be analyzed. All the data in this study were derived from the Nationwide Inpatient Sample database. The study determined the overall and lesion-specific incidences of CHD diagnoses among all birth hospitalizations in 2008, stratified by race, gender, socioeconomic status, and hospital geographic location. The study identified 13,093 CHD diagnoses among 1,204,887 birth hospitalizations, yielding an incidence of 10.8 per 1,000, with a predominance of mild lesions and septal defects. Atrial septal defect (ASD) and pulmonic stenosis were more common among females, whereas aortic stenosis, coarctation of the aorta, hypoplastic left heart syndrome, and d-transposition of great arteries were more common among males. No racial difference was observed in the overall CHD incidence. However, isolated patent ductus arteriosus (PDA) and ventricular septal defects (VSDs) were more common among Caucasians, whereas ASDs were more common among Hispanics. The incidences of CHD diagnoses were similar for all socioeconomic classes except the lowest socioeconomic class, which had a significantly lower CHD incidence. There was no geographic or seasonal variation in CHD incidence. This study demonstrated the incidence of echocardiographically confirmed CHD diagnosis to be 10.8 per 1,000 live births, marked by a high proportion of mild cardiac lesions and isolated PDAs. The high incidence of isolated PDAs in this study may be explained by the inclusion of only CHD diagnoses during birth hospitalization.
This is a preview of subscription content, log in to check access.
We acknowledge the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality for granting us unlimited access to their database. We also thank Ugochi Egbe and John Doucette for their contribution during data mining, statistical analysis, and proofreading.
Conflict of interest
The authors have no conflicts of interest to disclose.
Agency for Healthcare Research and Quality, Rockville, MD. HCUP Nationwide Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP), 1998–2008. www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed 22 July 2013
Bernier PL, Stefanescu A, Samoukovic G et al (2010) The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 13:26–34CrossRefPubMedGoogle Scholar
Correa-Villasenor A, McCarter R, Downing J et al (1991) White-black differences in cardiovascular malformations in infancy and socioeconomic factors. The Baltimore-Washington Infant Study Group. Am J Epidemiol 134:393–402PubMedGoogle Scholar
Dickinson DF, Arnold R, Wilkinson JL (1981) Congenital heart disease among 160,480 liveborn children in Liverpool 1960 to 1969: implications for surgical treatment. BMJ 46:55–62Google Scholar
Ferencz C, Rubin JD, Mccarter RJ et al (1985) Congenital heart-disease: prevalence at livebirth: the Baltimore Washington Infant Study. Am J Epidemiol 121:31–36PubMedGoogle Scholar
Fixler DE, Pastor P, Chamberlin M et al (1990) Trends in congenital heart disease in Dallas County births: 1971–1984. Circulation 81:137–142CrossRefPubMedGoogle Scholar
Flores G, Bauchner H, Feinstein AR et al (1999) The impact of ethnicity, family income, and parental education on children’s health and use of health services. Am J Public Health 89:1066–1071PubMedCentralCrossRefPubMedGoogle Scholar
Grabitz RG, Joffres MR, Collins-Nakai RL (1988) Congenital heart disease: incidence in the first year of life. The Alberta Heritage Pediatric Cardiology Program. Am J Epidemiol 128:381–388PubMedGoogle Scholar
Khoshnood B, Lelong N, Houyel L et al (2012) Prevalence, timing of diagnosis, and mortality of newborns with congenital heart defects: a population-based study. Heart 98:1667–1673CrossRefPubMedGoogle Scholar
Khoshnood B, Loane M, Garne E et al (2013) Recent decrease in the prevalence of congenital heart defects in Europe. J Pediatr 162(108–113):e102Google Scholar
Laursen HB (1980) Some epidemiological aspects of congenital heart disease in Denmark. Acta Paediatr Scand 69:619–624CrossRefPubMedGoogle Scholar
Lee K, Khoshnood B, Chen L et al (2001) Infant mortality from congenital malformations in the United States, 1970–1997. Obstet Gynecol 98:620–627CrossRefPubMedGoogle Scholar
Lim MK, Hanretty K, Houston AB et al (1992) Intermittent ductal patency in healthy newborn infants: demonstration by colour Doppler flow mapping. Arch Dis Child 67:1217–1218PubMedCentralCrossRefPubMedGoogle Scholar
Lindinger A, Schwedler G, Hense HW (2010) Prevalence of congenital heart defects in newborns in Germany: results of the first registration year of the PAN Study (July 2006 to June 2007). Klin Padiatr 222:321–326CrossRefPubMedGoogle Scholar
Mitchell SC, Korones SB, Berendes HW (1971) Congenital heart disease in 56,109 births incidence and natural history. Circulation 43:323–332CrossRefPubMedGoogle Scholar
Moons P, Sluysmans T, De Wolf D et al (2009) Congenital heart disease in 111,225 births in Belgium: birth prevalence, treatment, and survival in the 21st century. Acta Paediatr 98:472–477CrossRefPubMedGoogle Scholar
Robida A, Folger GM, Hajar HA (1997) Incidence of congenital heart disease in Qatari children. Int J Cardiol 60:19–22CrossRefPubMedGoogle Scholar
Samanek M, Voriskova M (1999) Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Pediatr Cardiol 20:411–417CrossRefPubMedGoogle Scholar
Tennstedt C, Chaoui R, Korner H et al (1999) Spectrum of congenital heart defects and extracardiac malformations associated with chromosomal abnormalities: results of a seven-year necropsy study. Heart 82:34–39PubMedCentralCrossRefPubMedGoogle Scholar
Van der Linde D, Konings EE, Slager MA et al (2011) Birth prevalence of congenital heart disease worldwide: a systematic review and metaanalysis. J Am Coll Cardiol 58:2241–2247CrossRefPubMedGoogle Scholar