Patterns, prevalence, risk factors, and survival of newborns with congenital heart defects in a Saudi population: a three-year, cohort case-control study

Abstract

BackgroundCongenital heart defects (CHD) are the most common types of birth defects. The prevalence of CHD, mostly from retrospective studies, ranges between 2.1 and 10.7/1000 live births. For physicians to provide appropriate health care, it is important to know the prevalence of CHD within their patient populations. In this prospective study, we assessed the prevalence, risk factors, types, and survival of CHD among babies born to Saudi mothers over a three-year period.MethodsIn this prospective cohort study, all women delivered at Prince Sultan Military Medical City, Saudi Arabia over a three-year period and were recruited during their antenatal care visits or at delivery. Antenatal foetal anomaly scan, postnatal clinical examination, echocardiography, cardiac catheterization, and follow-up to 2 years of age were used to assess the patterns, prevalence, and survival of babies with CHD. A case-control study was nested within the original cohort to assess risk factors for CHD.ResultsOf 28,646 eligible births, 424 babies were diagnosed with CHD (14.8/1000 births), and 91 of these babies had severe CHD (3.2/1000 births). Associated non-cardiac anomalies were found in 40.1% (170 of 424) of these babies. Trisomy 21 was the most frequent chromosomal anomaly. Within the first 2 years of life, 74 of 424 babies died (17.4%). Among mothers with infants who had CHD without associated non-cardiac anomalies, risk factors for CHD included maternal age ≥ 31 years, body mass index ≥30, insulin-dependent diabetes, and an occupation of an unemployed housewife.ConclusionIn the Saudi population we studied, the prevalence of CHD was higher than reported in other populations in the Middle East and in Europe. Plans to ameliorate modifiable risk factors and improve prenatal diagnosis of CHD are needed.