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The average prevalence of congenital heart defects in Europe is around eight per 1000 births, researchers report in Circulation.
That translates to "a significant burden of congenital heart defects," said investigator Dr Helen Dolk, "with an estimated 36,000 affected live births each year in the European Union, and 3,000 deaths in utero or in the first week of life."
Her study covered the years 2000 to 2005, but in Dr Dolk noted that the prevalence of congenital heart defects "increased during the 1990s and has been decreasing during the 2000s."
The increase in the 1990s was generally attributed to earlier and better diagnosis, she added.
For the current study, Dr Dolk of the University of Ulster in Northern Ireland and colleagues had access to a congenital anomalies central database involving 29 congenital anomaly registries covering 3.3 million births in 16 European countries.
Foetal anomalies
The researchers identified 26,598 heart defects in live births, foetal deaths from 20 weeks gestation, and terminations of pregnancy for foetal anomaly (TOPFA).
In 88% of cases the cardiac defect was not associated with a chromosomal anomaly; such cases accounted for 7 of every 1000 births in the population. There were wide variations by country, however. For example, the rate of babies born with a non-chromosomal heart defect was 4.65 per 1000 births in Spain and 13.90 in Austria.
Severe non-chromosomal defects occurred in 2.0 per 1000 births across Europe. About 8% of these resulted in perinatal death, 40% were prenatally diagnosed, and in 14% the pregnancy was terminated. Rates of TOPFA ranged from zero in Ireland and Malta, countries where abortion for any reason is illegal, to 1.1 per 1000 live births in France.
Live-born Down syndrome babies with congenital heart defects accounted for 0.5 of every 1000 births, but rates varied more than fourfold by country.
Summing up, Dr Dolk said, "By acting on what we already know about the causes of congenital heart defects, and particularly investing in research on their causes, we should be able to see many such children born healthy in the future."
"In the meantime," she concluded, "investment is needed in high quality cardiac services for successful early diagnosis and treatment, and to meet continuing needs throughout childhood and adulthood."
(Reuters Health, David Douglas, March 2011)
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