Congenital Heart Disease Prevention

Section one:Incidence of congenital heart disease in Beijing, Republic of China[Objective]Over the years,developed countries have been studying the incidence of congenital heart disease(CHD) from a number of different angles,and accumulated a wealth of epidemiological data.In contrast,China's research in this field is few.The research about incidence of CHD is still in its infancy stage in Beijing,it has been only limited to pre-school children.The purpose of this study was to investigate incidence of CHD in live births and stillbirths in Beijing.[Methods]The current study involved all babies with CHD among the 84,062 total births in Beijing during the period of January 1 and December 31,2007.An echocardiographic examination was performed on every baby suspected to have CHD, prenatally or/and postnatally.[Results]686 babies were shown to have CHD among 84,062 total births.The overall incidence was 8.2/1000 total births.Of 151 babies diagnosed prenatally,128 parents chose to terminate the pregnancy.The incidence of CHD in stillbirths and live births was 168.8/1000 and 6.7/1000,respectively.[Conclusions]The incidence of liveborn CHD in Beijing fell within the range reported for developed countries,but the incidences of some kinds of CHD were significant differences between them. Section two:Analysis about the impact of environmental risk factors on congenital heart disease in Beijing.[Objective]To explore the impact of environmental factors on congenital heart disease(CHD) in Beijing,to assess their effects in the occurrence of CHD and to provide a scientific basis for primary prevention of CHD.[Methods]A hospital-based 1:2 matched case-control study was conducted for parents of 200 cases and 400 normal children.We investigated their environmental factors such as dietary habits during pregnancy.By means of simple and multivariable conditional Logistic regression,all factors were analyzed.[Results]By the single-factor conditional Logistic regression,the study showed that 19 variables including age for pregnancy and the number of children were related to the occurrence of CHD.Maternal passive smoking,exposure to poisonous chemicals, cold,contraceptives,often eating salted or smoked food,maternal diabetes,paternal smoking and drinking were the key environmental risk factors contributing to CHD, while often eating vegetables,consuming vitamin daily,folate,regular prenatal care and eating pure water during pregnancy were protective factors for CHD by multivariable conditional Logistic regression.[Conclusions]Although it was not sure about the causal relationship between these factors and CHD,but the study had prompted that they had a significant impact. Strengthening and promoting health care during pregnancy remains the main task of primary prevention for CHD. Section three:Secondary prevention of congenital heart disease in Beijing[Objective]Since the early 1980s,fetal echocardiography has gradually changed from a marginal interest to an essential part of a pediatric cardiology in developed countries.Routine obstetrical screening for fetal cardiac abnormalities became well accepted in developed countries by the end of the 1980s.Prenatal echocardiographic screening for fetal CHD was first performed in Beijing in the early 2000s,but the impact was not clear.We evaluated the impact of fetal echocardiography on the incidence of liveborn CHD.[Methods]The current study involved all babies with congenital heart disease among the 84,062 total births in Beijing during the period of January 1 and December 31, 2007.An echocardiographic examination was performed on every baby suspected to have CHD,prenatally or/and postnatally.[Results]686 babies were shown to have CHD among 84,062 total births.The overall incidence was 8.2/1000 total births.Of 151 babies diagnosed prenatally,128 parents chose to terminate the pregnancy.The incidence of CHD in stillbirths and live births was 168.8/1000 and 6.7/1000,respectively.The difference between the incidence of CHD in the total birth and live birth in our study was highly significant(P <0.001).[Conclusion]Fetal echocardiography reduced significantly the incidence of liveborn CHD.