| BackgroundCongenital Heart Disease (CHD), which is the top birth defect during perinatal period in China, has become the major public health problem with impairing quality of birth population and threating the health of human beings. Currently, systematical and widespread data about the epidemic situation of CHD in China is lacking. In addition, the study on screening CHD for early newborns using Color Doppler Echocardiography, which shows better accuracy in the diagnosis of CHD, is rarely reported. As an important part of the Survey on Prevalence of Major Cardiovascular Diseases & Key Technology Research in China, the survey on prevalence of CHD among live births was conducted to screen newborns with CHD using Color Doppler Echocardiography, and data of consecutive early neonates (7 days after birth) who were born in the hospitals in rural and urban areas of eastern, central and western China were collected. Data analyzed in this study is part of the survey.ObjectiveThis study aimed to investigate the prevalence and influencing factors of CHD among live births (7 days after birth) in two cities of East China and to provide scientific evidence for the prevention, diagnosis, treatment and monitor of CHD among newborns.MethodsData analyzed in this study came from the survey on prevalence of CHD among live births which belonged to Key Projects in the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period. One hospital was selected randomly from Huzhou City, as well as Huaibei City. Two thousand one hundred newborns with gestational age of at least 28 weeks were recruited consecutively from each selected hospital between September 2013 and November 2014. Within 7 days after birth, data related to maternal general situation, maternal periconceptional influnencing factors exposure, and neonatal general condition was collected using unified questionnaires. Newborns’ CHDs were screened using Color Doppler Echocardiography within 0-7 days of life. The prevalence of CHD was indicated by per 1000 live births, and influencing factors of CHD for newborns were explored through univariate and multivariate analysis.ResultsA total of 4152 neonates were screening, and there were 2144 live births in Huzhou City, and 2008 in Huaibei City, respectively. Out of them, boys were 2189 (52.72%), the gestational age was 39.16 ± 1.47 weeks, and birth weight was 3374.67 ± 472.64 g. The age of mother was 26.32±4.10 years old, and 99.35% mothers was the Han nationality. A total of 311 live births with CHD were identified, and the overall prevalence of CHD was 74.9%o. The most common CHD was atrial septal defect (ASD,60.5%o), followed by ventricular septal defect (VSD,12.8%o). The prevalence of CHD among live infants in Huzhou City and Huaibei City were 80.2%o and 69.2%o, respectively, and there were no significant differences between two cities (P>0.05). The prevalence of CHD was 70.8%o for boys, and 79.5%o for girls, and the prevalences of CHD were no significant difference between sexes (P>0.05). Multivariate logistic regression analysis showed that maternal pre-pregnancy underweight (OR=1.379,95% CI:1.053～1.805, P=0.0195) or obesity (OR=3.204,95% CI:1.716～5.984, P=0.0003), maternal decoration exposure (OR=1.590, 95% CI:1.034～2.443, P=0.0345) were indepandent risk factors of CHD in newborns in two cities of East China; maternal pre-pregnancy underweight (OR=1.419,95% CI: 1.050～1.917, P=0.0228) or obesity (OR=3.444,95% CI:1.783～6.651, P=0.0002), maternal decoration exposure (OR=1.736,95% CI:1.097～2.746, P=0.0184), macrosomic infants (OR=1.608,95% CI:1.047～2.469, P=0.0300), and lower Apgar Score of ten minute (OR=0.493,95% CI:0.268～0.904, P=0.0224) could increase the risk of ASD in newborns; maternal drug use in early pregnancy was associated with an increased risk for VSD. The risk factors were various for different types of CHD.ConclusionThe prevalence of CHD was higher among newborns in two cities of East China, and various types of CHD had different risk factors. It was needed to prevent and reduce the incidence and mortality of CHD by being targeted comprehensive interventions, enhancing health education for fertile women, and strengthening early screen for CHD among live births. |
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