Global, regional, and national burden of congenital heart disease, 1990-2021: a systematic analysis for the global burden of disease study 2021.

IF 3 3区医学 Q1 PEDIATRICS

European Journal of Pediatrics Pub Date : 2025-03-15 DOI:10.1007/s00431-025-06085-w

Xiaoling Zhang, Yuxuan Feng, Jiajia Ren, Xuting Jin, Jiamei Li, Yanli Hou, Ruohan Li, Lingzhi Qin, Wanyuan Liu, Yawen Yang, Qingmiao Ma, Gang Wang

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引用次数: 0

Abstract

Congenital heart disease (CHD) is a major birth defect characterized by structural and functional heart abnormalities. This study provides updated estimates of CHD prevalence, mortality, and disability using the Global Burden of Disease (GBD) 2021 database. We examined the age-standardized rates of CHD prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021, stratified by gender, age group, and region. Temporal trends were evaluated using the estimated annual percentage change (EAPC), and associations with the Socio-Demographic Index (SDI) were examined to evaluate the influence of socioeconomic development. From 1990 to 2021, the global age-standardized prevalence rate (ASPR) of CHD remained stable (EAPC: 0.04%, 95% CI: 0.03%-0.05%), while the age-standardized mortality rate (ASMR) (EAPC: -2.38%, 95% CI: -2.44% to -2.32%) and DALYs rate (EAPC: -2.34%, 95% CI: -2.40% to -2.28%) showed significant declines. Among the SDI quintiles, low-SDI regions had the highest ASMR and age-standardized DALYs rates, whereas high-SDI regions demonstrated the highest ASPR. Males experienced higher ASMR and age-standardized DALYs rates than females. Meanwhile, infants under 28 days exhibited the highest prevalence rate (1,539.77 per 100,000 population, 95% UI: 1,309.62 to 1,805.88), mortality rate (760.25 per 100,000 population, 95% UI: 609.51 to 944.66), and DALYs rate (68,489.79 per 100,000 population, 95% UI: 54,902.56 to 85,088.24) in 2021.

Conclusion: Despite the global decline in CHD-related mortality and DALYs, targeted strategies are crucial for low-SDI regions, males, and infants under 28 days. Improving prenatal screening, maternal nutrition, and pediatric cardiology services can address persistent disparities in CHD outcomes.

What is known: • Congenital heart disease (CHD), characterized by structural and functional heart abnormalities during embryonic development, is one of the most common type of congenital defects. • While the global age-standardized mortality rate (ASMR) related to CHD declined significantly from 1990 to 2017, it remained notably high in low-SDI and lower-middle-SDI regions in 2017.

What is new: • Infants under 28 days of age had the highest prevalence, mortality, and Disability-Adjusted Life Years (DALYs) rates related to CHD. • Males had higher ASMR and age-standardized DALYs rates compared to females.

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先天性心脏病（CHD）是一种以心脏结构和功能异常为特征的重大出生缺陷。本研究利用 2021 年全球疾病负担（GBD）数据库对先天性心脏病的患病率、死亡率和残疾率进行了最新估算。我们研究了 1990 年至 2021 年期间按性别、年龄组和地区分层的 CHD 患病率、死亡率和残疾调整生命年（DALYs）的年龄标准化比率。采用估计年度百分比变化（EAPC）对时间趋势进行了评估，并研究了与社会人口指数（SDI）的关联，以评估社会经济发展的影响。从 1990 年到 2021 年，全球慢性阻塞性肺疾病的年龄标准化患病率（ASPR）保持稳定（EAPC：0.04%，95% CI：0.03%-0.05%），而年龄标准化死亡率（ASMR）（EAPC：-2.38%，95% CI：-2.44%--2.32%）和残疾调整寿命年数（DALYs）率（EAPC：-2.34%，95% CI：-2.40%--2.28%）则显著下降。在 SDI 五分位数中，低 SDI 地区的 ASMR 和年龄标准化 DALYs 率最高，而高 SDI 地区的 ASPR 最高。男性的 ASMR 和年龄标准化 DALYs 率均高于女性。同时，28 天以下婴儿的患病率（每 100,000 人 1,539.77 例，95% UI：1,309.62 至 1,805.88）、死亡率（每 100,000 人 760.25 例，95% UI：609.51 至 944.66）和残疾调整寿命年数率（每 100,000 人 68,489.79 例，95% UI：54,902.56 至 85,088.24）在 2021 年都是最高的：尽管 CHD 相关死亡率和残疾调整寿命年数在全球范围内有所下降，但有针对性的策略对于低 SDI 地区、男性和 28 天以下婴儿至关重要。改善产前筛查、孕产妇营养和儿科心脏病学服务可以解决先天性心脏病结果方面持续存在的差异：- 先天性心脏病（CHD）以胚胎发育过程中心脏结构和功能异常为特征，是最常见的先天性缺陷之一。- 虽然与先天性心脏病相关的全球年龄标准化死亡率（ASMR）从1990年到2017年显著下降，但2017年在低SDI和中下SDI地区仍然明显偏高：- 出生28天以下的婴儿与先天性心脏病相关的患病率、死亡率和残疾调整生命年（DALYs）最高。- 与女性相比，男性的ASMR和年龄标准化残疾调整生命年率更高。

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来源期刊

European Journal of Pediatrics 医学-小儿科

CiteScore

5.90

自引率

2.80%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.