Deaths Decline in Kids With Heart Defects
DALLAS — The number of children dying from congenital heart defects in the United States has decreased dramatically over the last two decades.
Researchers studying death certificates nationwide from 1979 to 1997 found that deaths from heart defects among people of all ages declined 39% during the period, from 2.5 per 100,000 population in 1979 to 1.5 per 100,000 population in 1997.
Deaths fell especially sharply among children under 5. For example, the number of deaths among infants in 1995 to 1997 was half that recorded in 1979 to 1981.
The drop is probably due to improved diagnosis, better surgical techniques and advances inintensive care, said Dr. Lorenzo D. Botto, one of the study’s authors.
“We found a quite impressive decline in mortality over 20 years,” said Botto, medical epidemiologist at the National Center on Birth Defects and Developmental Disabilities at the federal Centers for Disease Control and Prevention in Atlanta.
The researchers found that fewer youngsters died from congenital heart defects even though just as many children were born with the problem.
However, Botto said heart anomalies remain a major cause of infant death. He noted that in the last three years of the study period, one in 10 deaths of children age 1 and younger was associated with a heart anomaly.
Why such defects occur is not known, but scientists believe that a combination of genetic and environmental factors is responsible.
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Dr. David Fixler, professor of pediatrics at the University of Texas Southwestern Medical Center at Dallas, said better dissemination of new techniques and drug treatments through scientific journals and conferences also helped reduce deaths.
The study was published in Tuesday’s issue of the American Heart Assn. journal Circulation.
Congenital heart defects, which are heart abnormalities present at birth, are diagnosed in about one in every 100 to 150 newborns in the United States, according to the study.
They include malformations in which the two main arteries exiting the heart are switched, and a defect in which the left side of the heart is so poorly developed it cannot sustain blood circulation.
The death rate was higher and declined more slowly among blacks than among whites. From 1995 to 1997, for example, infant mortality from heart defects was 23% higher among blacks (68.43 per 100,000 population) than among whites (55.51 per 100,000).
The study did not explain the racial differences, but the researchers theorized they could be related to access to health care, rate of complications or differences in severity of the defects.
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Heart Defects
Children’s mortality rates from congenital heart defects have fallen precipitously over the last 20 years.
Deaths from heart defects
Per 100,000 people in age group
Less than 1 year old
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‘79-’81 ‘95-’97 All 92.16 56.46 White 90.88 55.51 Black 99.87 68.43 Male 101.37 62.41 Female 82.51 50.24
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Ages 1 to 4
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‘79-’81 ‘95-’97 All 4.59 1.98 White 4.54 1.76 Black 4.93 3.00 Male 4.84 2.07 Female 4.24 1.88
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Source: Centers for Disease Control and Prevention
