One-year survival up for critical congenital heart defects

April 22, 2013
One-year survival up for critical congenital heart defects
For infants with critical congenital heart defects, one-year survival has improved over time, with an increased risk of mortality associated with earlier diagnosis, low birth weight, and maternal age, according to a study published online April 22 in Pediatrics.

(HealthDay)—For infants with critical congenital heart defects (CCHDs), one-year survival has improved over time, with an increased risk of mortality associated with earlier diagnosis, low birth weight, and maternal age, according to a study published online April 22 in Pediatrics.

Matthew E. Oster, M.D., M.P.H., from the U.S. in Atlanta, and colleagues conducted a retrospective population-based cohort study in infants born with structural (CHDs) from 1979 to 2005. The authors sought to examine trends in survival and identify prognostic factors for survival.

The researchers found that 6,985 of the 1,056,541 births were infants with CHDs (1,830 with CCHDs). For those with CCHDs, the one-year survival was 75.2 percent, compared with 97.1 percent for those with noncritical CHDs. From the 1979 to 1993 birth era to the 1994 to 2005 era, one-year survival for infants with CCHDs improved from 67.4 to 82.5 percent. In infants diagnosed at ≤1 day of age versus >1 day of age, the one-year survival was significantly lower (71.7 versus 82.5 percent). The risk of one-year mortality was significantly increased with earlier birth era, earlier diagnosis, , and for those whose mothers were younger than 30 years.

"One-year survival for infants with CCHDs has been improving over time, yet mortality remains high," the authors write. "As such, improving survival from CCHDs remains an opportunity for public health action."

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ericbrad
not rated yet Apr 23, 2013
"increased risk of mortality associated with earlier diagnosis" would seem to imply that detecting a CHD in utero somehow leads to a worse prognosis. I'm guessing that this correlation across the entire sample is due to the fact that a more severe CHD is more likely to be detected in utero, and that these more severe CHDs carry a higher mortality risk.

Unless the article draws a line between early detection and higher mortality *for a given child*, this point should be clarified, as early diagnosis is very important in my opinion, and in the opinions of the highly skilled medical professionals that treated our son.

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