@Article{chd.12672,
AUTHOR = {Mohd Nizam Mat Bah, Mohd Hanafi Sapian, Mohammad Tamim Jamil, Nisah Abdullah, Emieliyuza Yusnita Alias, Norazah Zahari},
TITLE = {The birth prevalence, severity, and temporal trends of congenital heart disease in the middle‐income country: A population‐based study},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {6},
PAGES = {1012--1027},
URL = {http://www.techscience.com/schd/v13n6/39083},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> There is limited data on congenital heart disease (CHD) from the lower‐ 
and middle‐income country. We aim to study the epidemiology of CHD with the 
specific objective to estimate the birth prevalence, severity, and its trend over time.<br/>
<b>Design:</b> A population‐based study with data retrieved from the Pediatric Cardiology 
Clinical Information System, a clinical registry of acquired and congenital heart dis‐
ease for children.<br/>
<b>Setting:</b> State of Johor, Malaysia.<br/>
<b>Patients:</b> All children (0‐12 years of age) born in the state of Johor between January 
2006 and December 2015.<br/>
<b>Intervention:</b> None.<br/>
<b>Outcome measure:</b> The birth prevalence, severity, and temporal trend over time.<br/>
<b>Results:</b> There were 531 ,904 live births during the study period with 3557 new cases 
of CHD detected. Therefore, the birth prevalence of CHD was 6.7 per 1000 live 
births (LB) (95% confidence interval [CI]: 6.5‐6.9). Of these, 38% were severe, 15% 
moderate, and 47% mild lesions. Hence, the birth prevalence of mild, moderate, and 
severe CHD was 3.2 (95% CI: 3.0‐3.3), 0.9 (95% CI: 0.9‐ 1.1), and 2.6 (95% CI: 2.4‐2.7) 
per 1000 LB, respectively. There was a significant increase in the birth prevalence of 
CHD, from 5.1/1000 LB in 2006 to 7.8/1000 LB in 2015 (P < .0001) due to increase 
in detection of both mild (1.9/1000 LB in 2006 to 3.9/1000 LB in 2015, P < .001) and 
severe CHD (1.8/1000 LB in 2005 to 2.9/1000 LB in 2015, P < .001).<br/>
<b>Conclusions:</b> The birth prevalence of CHD was 6.7 per 1000 live births, and two in 
five were severe and significantly associated with syndrome and extracardiac defect. 
There was a significant increase in the detection of severe lesions in recent years 
leading to more burden to resources that are already limited in the middle‐income 
country. Therefore, strategic and comprehensive pediatric and congenital heart sur‐
gery program is required.},
DOI = {10.1111/chd.12672}
}