Epidemiological Survey Of Congenital Heart Disease Among Newborns Born In A Hospital From 2015 To 2019

Objective:The etiology of neonatal Congenital heart disease(CHD)is not completely clear,so an epidemiological investigation is conducted to understand the incidence and classification of CHD in neonates born with live births,so as to explore the etiology of CHD and related risk factors leading to its occurrence.To provide scientific basis for prevention,early diagnosis and timely treatment of CHD.Methods:All live neonates born in a third-grade A general hospital from January 1,2015 to December 31,2019 were selected as the research subjects.Infants diagnosed as CHD through neonatal CHD screening were set as the case group,and healthy neonates at the same period were randomly selected as the control group.The survey included:1)newborn sex,gestational age,number of births,birth weight,time of diagnosis(prenatal or postnatal),history of asphyxia,extracardial malformation,etc.;2)The mother’s home place,age,occupation,education level,ethnicity,adverse pregnancy history,close relatives,active/passive smoking,drinking history,drug history,exposure to harmful environment(newly decorated house,physical radiation),medication history,upper respiratory tract infection history in early pregnancy;3)Complicated diseases during pregnancy:such as diabetes,gestational hypertension,hypothyroidism,hyperthyroidism,hypoproteinemia,anemia,hyperlipidemia,hyperuricemia,thrombocytopenia,etc.;4)Prognosis:natural closure,clinical observation,drug,intervention,surgical intervention,failure to recover after treatment,death,loss of follow-up,etc.The survey contents of all enrolled newborns were filled into the self-designed questionnaire,and the database was established for statistical analysis.Results:1.A total of 27,054 live births were recorded from 2015 to 2019,of which 261 infants diagnosed with CHD were selected as the case group,and 261 healthy neonates in the same period were randomly selected as the control group.There was no statistical difference in general neonatal data between the two groups(X~2=1.042,P>0.05).The incidence of CHD in this study was 9.6‰,including 118 males and 143 females,and the male to female ratio was1:1.2,the difference was statistically significant(X~2=4.209,P=0.04).A comparison of the incidence of CHD in live births from 2015 to 2019 showed that the incidence of CHD in 2017,2018 and 2019 was statistically significant compared with that in 2015 and 2016(X~2=77.367,P<0.001).The incidence of neonatal CHD in live births from 2015 to 2019 has increased significantly since 2016.2.The composition ratio of CHD occurrence types is as follows:There were 159 cases of Patent ductus arteriosus(PDA),60.92%,43 cases of Ventricular septal defect(VSD),16.45%.Atrial septal defect(ASD)in 32 cases(12.26%),VSD+PDA in 6 cases(2.30%),VSD+ASD in5 cases(1.92%),TOF of Fallot in 3 cases(1.15%).Pulmonary stenosis(PS)was found in 2cases(0.77%),Persistent left superior vena cava(PLSVC)in 2 cases(0.77%),and other types in 9 cases(3.45%).3.According to the pathological types of CHD,CHD was classified into latent cylinic type(245 cases,93.87%),cylinic type(12 cases,4.60%)and non-cylinic type(4 cases,4.53%).4.There were 14 cases(5.4%)of CHD children with extracardiac abnormalities.Among 261CHD children,31 cases were diagnosed by fetal echocardiography,and the prenatal diagnosis rate was 11.88%.5.Analysis of CHD risk factors:Univariate correlation analysis was carried out on 27 factors to screen out 16 statistically significant related factors,and then multivariate unconditional logistic regression analysis was carried out on the significant single factors.The results showed that within a certain range,the smaller the gestational age and birth weight,the greater the possibility of CHD.Suffocation(OR=5.59),upper respiratory tract infection in early pregnancy(OR=3.61)and active/passive smoking(OR=3.69)were high risk factors for neonatal CHD.The occupation of the pregnant mother as a public servant(OR=0.57)was a protective factor for CHD.6.Prognosis of CHD:A total of 241 cases(92.34%)of the 261 children with CHD were followed up,among which 190 cases(72.80%)were naturally closed,5 cases(1.92%)were treated,40 cases(15.32%)were treated with drugs,intervention and surgery,2 cases(0.77%)did not recover after treatment,and 4 cases(1.53%)died.The remaining 20 cases(7.66%)were lost to follow-up.Conclusion:1.In this study,the incidence of CHD in live births was 9.6‰,and the male to female ratio was 1:1.2;The incidence of CD has been increasing year by year since 2016.PDA was the most important type of CHD.Latent cyan type is the most common.2.The lower the gestational age and birth weight,the higher the probability of CHD;Asphyxia,upper respiratory tract infection in early pregnancy and active/passive smoking are risk factors for CHD.The occupation of the pregnant mother as a public servant was a protective factor for CHD.3.More than 95% of CHD children in this study had a good prognosis.