拉丁美洲和加勒比地区婴儿先天性心脏病死亡率和单室心:法属圭亚那人口研究

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
H. Lucron , M. Brard , J. D’orazio , L. Long , A. Le Harrivel De Gonneville , S. Tuttle , N. Elenga , J. Inamo , D. Bonnet , R. Banydeen
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引用次数: 0

摘要

导言除了全球疾病负担(GBD)研究的预测外,拉丁美洲和加勒比地区(LAC)的先天性心脏病(CHD)负担仍未确定,尤其是功能性单心室心(FUH)等复杂类型的先天性心脏病,其发病率和死亡率较高。方法对2012年1月至2016年12月期间所有胎儿和活产(LB)CHD病例进行基于人群的登记分析。结果共诊断出231例CHD,其中56例为胎儿诊断,215例为LB诊断。在所有先天性心脏病病例(n = 231)中,染色体或基因异常占 18.6%,因胎儿异常而终止妊娠占 6.5%。总的先天性心脏病发病率为每 10,000 人中有 68.4 例 [95% CI:67.9-68.8] ,枸橼酸先天性心脏病发病率为每 10,000 人中有 65.2 例 [95% CI:64.7-65.7],与《全球儿童发展报告》对 TLA 的预测相似。研究样本中的婴儿总死亡率为 9.4/10,000 LB [95% CI:9.1-9.7]。FUH患儿的死亡率最高。与法国本土相比,法属圭亚那的FUH总发病率明显更高(P = 0.03),LB FUH发病率和相关婴儿死亡率也分别高出两到三倍(P < 0.01)。然而,与《全球人口发展报告》对塔拉地区的预测相比,FUH 的流行率并无明显差异。由于缺乏 GBD 数据,因此无法对 FUH 婴儿死亡率进行对比。结论这项在世界该地区进行的首次基于人口的研究表明,拉丁美洲和加勒比地区的先天性心脏病具有独特的特征,其发病率和死亡率的升高与 FUH 有关。超高死亡率风险的另一个潜在决定因素可能是染色体或基因异常的频繁出现。这为更好地了解先天性心脏病的负担和潜在的特殊性奠定了基础,同时也为今后降低法属圭亚那和其他周边国家的婴儿死亡率提供了关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Infant congenital cardiac mortality and univentricular hearts in Latin America and Caribbean: A population-based study in French Guiana

Introduction

Except for projections from the Global Burden of Disease (GBD) study, congenital heart disease (CHD) burden remains undetermined in Latin America and Caribbean (LAC), especially for complex types such as functionally univentricular hearts (FUH) responsible for higher disease morbidity and mortality.

Objective

To describe CHD prevalence, characteristics and related infant mortality in French Guiana, a LAC territory.

Methods

Population-based registry analysis of all fetal and live birth (LB) CHD cases from January 2012 to December 2016.

Results

Overall, 231 CHD were diagnosed, among which 56 fetal diagnoses and 215 resulting LB. Among all CHD (n = 231), there were 18.6% of chromosomal or genetic anomalies, and 6.5% of termination of pregnancy for fetal anomaly. Total and LB CHD prevalence were respectively 68.4 [95% CI: 67.9–68.8] and 65.2 [95% CI: 64.7–65.7] per 10,000, similar to GBD projections for TLA. The total infant mortality in the study sample was 9.4/10,000 LB [95% CI: 9.1–9.7]. Children with FUH presented the highest mortality rates. When compared to mainland France, total FUH prevalence for French Guiana was significantly higher (P = 0.03), as were LB FUH prevalence and related infant mortality respectively two to three-fold higher (P < 0.01). However, no significant difference was observed for FUH prevalence when compared to GBD projections for TLA. FUH infant mortality could not be contrasted due to the lack of GBD data.

Conclusion

This first population-based study ever performed in this part of the world suggests a distinct profile for CHD in the LAC region, with elevated prevalence and mortality rates linked to FUH. Another potential determinant of the excess mortality risk might be the frequent presence of chromosomal or genetic anomalies. This constitutes a stepping-stone towards better understanding CHD burden and underlying specificities while providing future keys towards reducing infant mortality in French Guiana and others surrounding countries.

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来源期刊
Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases 医学-心血管系统
CiteScore
4.40
自引率
6.70%
发文量
87
审稿时长
34 days
期刊介绍: The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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