Global, regional, and national burden of congenital heart disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
Authors: Meghan S Zimmerman, Alison Grace Carswell Smith, Craig A Sable, Michelle Marie Echko, Lauren B Wilner, Helen Elizabeth Olsen, Hagos Tasew Atalay, Ashish Awasthi, Zulfiqar A Bhutta, Jackie LeeAnne Boucher, Franz Castro, Paolo Angelo Cortesi, Manisha Dubey, Florian Fischer, Samer Hamidi, Simon I Hay, Chi Linh Hoang, Christopher Hugo-Hamman, Kathy J Jenkins, Anita Kar, Ibrahim A Khalil, Raman Krishna Kumar, Gene F Kwan, Desalegn Tadese Mengistu, Ali H Mokdad, Mohsen Naghavi, Lemma Negesa, Ionut Negoi, Ruxandra Irina Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Long Hoang Nguyen, Son Hoang Nguyen, Trang Huyen Nguyen, Molly R Nixon, Jean Jacques Noubiap, Shanti Patel, Emmanuel K Peprah, Robert C Reiner, Gregory A Roth, Mohamad-Hani Temsah, Marcos Roberto Tovani-Palone, Jeffrey A Towbin, Bach Xuan Tran, Tung Thanh Tran, Nu Thi Truong, Theo Vos, Kia Vosoughi, Robert G Weintraub, Kidu Gidey Weldegwergs, Zoubida Zaidi, Bistra Zheleva, Liesl Zuhlke, Christopher J L Murray, Gerard R Martin, Nicholas J Kassebaum
Journal: The Lancet Child & Adolescent Health (2020)

BackgroundPrevious congenital heart disease estimates came from few data sources, were geographically narrow, and did not evaluate congenital heart disease throughout the life course. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, this study aimed to provide comprehensive estimates of congenital heart disease mortality, prevalence, and disability by age for 195 countries and territories from 1990 to 2017.MethodsMortality estimates were generated for aggregate congenital heart disease and non-fatal estimates for five subcategories (single ventricle and single ventricle pathway congenital heart anomalies; severe congenital heart anomalies excluding single ventricle heart defects; critical malformations of great vessels, congenital valvular heart disease, and patent ductus arteriosus; ventricular septal defect and atrial septal defect; and other congenital heart anomalies), for 1990 through to 2017. All available global data were systematically analysed to generate congenital heart disease mortality estimates (using Cause of Death Ensemble modelling) and prevalence estimates (DisMod-MR 2·1). Systematic literature reviews of all types of congenital anomalies to capture information on prevalence, associated mortality, and long-term health outcomes on congenital heart disease informed subsequent disability estimates.FindingsCongenital heart disease caused 261 247 deaths (95% uncertainty interval 216 567–308 159) globally in 2017, a 34·5% decline from 1990, with 180 624 deaths (146 825–214 178) being among infants (aged <1 years). Congenital heart disease mortality rates declined with increasing Socio-demographic Index (SDI); most deaths occurred in countries in the low and low-middle SDI quintiles. The prevalence rates of congenital heart disease at birth changed little temporally or by SDI, resulting in 11 998 283 (10 958 658–13 123 888) people living with congenital heart disease globally, an 18·7% increase from 1990 to 2017, and causing a total of 589 479 (287 200–973 359) years lived with disability.InterpretationCongenital heart disease is a large, rapidly emerging global problem in child health. Without the ability to substantially alter the prevalence of congenital heart disease, interventions and resources must be used to improve survival and quality of life. Our findings highlight the large global inequities in congenital heart disease and can serve as a starting point for policy changes to improve screening, treatment, and data collection.FundingBill & Melinda Gates Foundation.