Abstract
<b>Objectives:</b> To estimate the prevalence of Congenital Heart Disease (CHD) in school-age children, to identify the extent to which altitude affects the prevalence of the disease, and to examine trends in prevalence over time in China. <b>Methods:</b> Seven databases were systematically searched and last retrieved on September 10, 2021 for all studies reporting the prevalence of CHD in children after 1970 in China, which were then divided into high and low altitude regions based on 2500 meters above sea level. The random-effected model was used to combine prevalence data and subgroups analysis. The baseline data of all cases and individuals were used for comparison to calculate the odds ratio (OR) for overall and different altitude prevalence. <b>Results:</b> A total of 12,926,083 individuals (aged 3-18 years), with 31,835 cases from 86 studies, were included in the analysis. The pooled CHD prevalence of total children was 4.69 [95% confidence interval (CI): 4.10 to 5.29] per 1000 children. Overall, temporal trends analysis indicated that the prevalence of CHD in children continuously decreased with time, from 6.19 (95% CI: 4.50 to 7.88) per 1000 children in 1976–1985 to 3.30 (95% CI: 2.49; 4.38) per 1000 children in 2016–2021. The OR for the prevalence of CHD in children from high and low altitudes with baseline data was 2.84 (95% CI: 2.48 to 3.27) and 1.31 (95% CI: 1.13 to 1.53) (<i>χ</i><sup>2</sup> = 53.89, <i>p</i> < 0.01), respectively. The OR of the prevalence of CHD in male children compared to females was 0.60 (95% CI: 0.53 to 0.68) at high altitudes and 0.79 (95% CI: 0.71 to 0.89) at low altitudes. Among the seven most common subtypes, patent ductus arteriosus was the most common at high altitudes, while atrial septal defects were the most common at low altitudes. <b>Conclusion:</b> This study provides valuable insights for further disease prevention and etiological exploration. The overall decreasing trend in the prevalence of CHD in children over time may indicate a positive effect of perinatal management and treatment during infancy.
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