TRENDS IN THE INCIDENCE AND CHARACTERISTICS OF CONGENITAL HEART DISEASE IN LOPBURI PROVINCE, CENTRAL THAILAND, 2017-2021

Abstract

Background: Congenital heart disease (CHD) is the newborn’s most common congenital anomaly. Nevertheless, limited evidence is available of CHD incidence in Thailand. Therefore, we aimed to determine the trends in CHD incidence from 2017 to 2021.
 Methods: A descriptive epidemiology study was conducted using data from 2017-2021. We collected data from the medical records of pediatric patients with CHD at the Pediatric Cardiology Clinic at Ananda Mahidol Hospital, central Thailand. The pediatric cardiologist reviewed medical records to obtain participants’ characteristics and medical data, including CHD diagnosis, sex, child order and maternal risk factors during pregnancy.
 Results: In total, 27,882 live births were recorded between 2017 and 2021 in Lopburi Province, Thailand. The study included 584 pediatric patients with CHD born between 2017 and 2021. Of these, 312 (53.4%) were males, and 89 (15.2%) presented cyanotic CHD. Sex-adjusted CHD incidence was 22.4 per 1000 live-births (95% CI: 17.6-34.5) in 2017; then rose to 25.7 per 1000 live-births (95% CI 21.7- 30.2) in 2019 and dropped to 15.4 per 1000 live-births (95% CI 12.1-19.3) in 2021 (p for trend = 0.317). Two hundred and fourteen patients (36.6%) presented a ventricular septal defect. In 2017, the proportion of patients receiving a diagnosis of CHD before one year of age was 57.7% and continuously rose to 100% in 2021 (p-for trend <0.001). The proportion of alcohol consumption during pregnancy was consistently high, ranging from 61.6 to 74.8% (p for trend = 0.189). In addition, contraindicated drug use during the first trimester of pregnancy was also constantly high (73.1%) among study participants over five years (p for trend = 0.235).
 Conclusion: CHD incidence in Lopburi Province has been persistently high from 2017 to 2021. The average age at diagnosis with CHD in this study population continuously declined over five years. Characteristics of CHD risk factors during pregnancy constituted a constantly high proportion among these study participants over one half decade.