Temporal Trends of Infant Mortality Secondary to Congenital Heart Disease: National CDC Cohort Analysis (1999–2020)

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY Birth Defects Research Pub Date : 2024-09-02 DOI:10.1002/bdr2.2398

Muchi Ditah Chobufo, Shafaqat Ali, Amro Taha, Sanchit Duhan, Neel Patel, Karthik Gonuguntla, Dipesh Ludhwani, Harshith Thyagaturu, Bijeta Keisham, Ayesha Shaik, Anas Alharbi, Yasar Sattar, Mamas A. Mamas, Utkarsh Kohli, Sudarshan Balla

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Abstract

Background

Infant mortality continues to be a significant problem for patients with congenital heart disease (CHD). Limited data exist on the recent trends of mortality in infants with CHD.

Methods

The CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was queried to identify deaths occurring within the United States with CHD listed as one of the causes of death between 1999 and 2020. Subsequently, trends were calculated using the Joinpoint regression program (version 4.9.1.0; National Cancer Institute).

Results

A total of 47,015 deaths occurred in infants due to CHD at the national level from the year 1999 to 2020. The overall proportional infant mortality (compared to all deaths) declined (47.3% to 37.1%, average annual percent change [AAPC]: −1.1 [95% CI −1.6 to −0.6, p < 0.001]). There was a significant decline in proportional mortality in both Black (45.3% to 34.3%, AAPC: −0.5 [−0.8 to −0.2, p = 0.002]) and White patients (55.6% to 48.6%, AAPC: −1.2 [−1.7 to −0.7, p = 0.001]), with a steeper decline among White than Black patients. A statistically significant decline in the proportional infant mortality in both non-Hispanic (43.3% to 33.0%, AAPC: −1.3% [95% CI −1.9 to −0.7, p < 0.001]) and Hispanic (67.6% to 57.7%, AAPC: −0.7 [95% CI −0.9 to −0.4, p < 0.001]) patients was observed, with a steeper decline among non-Hispanic infant population. The proportional infant mortality decreased in males (47.5% to 53.1%, AAPC: −1.4% [−1.9 to −0.9, p < 0.001]) and females (47.1% to 39.6%, AAPC: −0.9 [−1.9 to 0.0, p = 0.05]). A steady decline in for both females and males was noted.

Conclusion

Our study showed a significant decrease in CHD-related mortality rate in infants and age-adjusted mortality rate (AAMR) between 1999 and 2020. However, sex-based, racial/ethnic disparities were noted, with female, Black, and Hispanic patients showing a lesser decline than male, White, and non-Hispanic patients.

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先天性心脏病导致婴儿死亡的时间趋势：全国疾病预防控制中心队列分析（1999-2020 年）》。

背景：婴儿死亡率仍然是先天性心脏病（CHD）患者面临的一个重要问题。有关先天性心脏病婴儿死亡率最新趋势的数据有限：方法：我们查询了美国疾病控制与预防中心的 WONDER（美国疾病控制与预防中心流行病学研究广泛在线数据），以确定 1999 年至 2020 年期间在美国境内发生的、死因之一为先天性心脏病的死亡病例。随后，使用Joinpoint回归程序（4.9.1.0版；美国国家癌症研究所）计算了趋势：结果：从 1999 年到 2020 年，全国共有 47 015 例婴儿死于心脏病。婴儿总死亡率（与所有死亡相比）有所下降（从 47.3% 降至 37.1%，年均百分比变化 [AAPC]：-1.1 [95% CI -1.6 至 -0.6，p 结论：我们的研究表明，CHD 导致的婴儿死亡率显著下降：我们的研究表明，1999 年至 2020 年间，婴儿的冠心病相关死亡率和年龄调整死亡率（AAMR）均有显著下降。然而，我们注意到了性别、种族/人种方面的差异，女性、黑人和西班牙裔患者的下降幅度低于男性、白人和非西班牙裔患者。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.