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Prevalência de Cardiopatias Congénitas em Portugal em 2015: Dados do Registo Nacional de Anomalias Congénitas
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Advisor(s)
Abstract(s)
Introdução: A prevalência de cardiopatias congénitas em Portugal é de 8,3/1000 nascimentos; cardiopatias congénitas críticas não
detectadas podem resultar em graves consequências para o feto/recém-nascido. O objectivo deste trabalho é descrever os casos de
cardiopatia congénita reportados em Portugal em 2015 quanto ao diagnóstico pré-natal, patologia cardíaca e à presença de outras
malformações congénitas ou anomalias cromossómicas. Estas características são comparadas nos subgrupos dos nados-vivos e de
interrupção médica da gravidez. Por último, caracterizam-se os óbitos.
Material e Métodos: Os dados de cardiopatias congénitas reportadas ao Registo Nacional de Anomalias Congénitas em 2015 foram
analisados, e calculadas as taxas de prevalência por 1000 nascimentos, comparadas utilizando teste de independência do quiquadrado.
Resultados: A prevalência de cardiopatias congénitas neste estudo foi de 5/1000, (339 nados-vivos, 20% com cardiopatias congénitas
críticas). As cardiopatias mais frequentes foram as seguintes: comunicação interventricular (38%), comunicação interauricular (15%),
coartação da aorta (7%), tetralogia de Fallot (7%) e estenose pulmonar (5%). Um terço dos nados-vivos teve diagnostico pré-natal de
cardiopatia. Dos nados-vivos com cardiopatias congénitas críticas, 54% teve diagnostico pré-natal e 14% foi diagnosticado ao nascer.
Foram identificados 84 registos de interrupção médica da gravidez; 49% apresentava cardiopatias congénitas críticas, 75% outras
malformações associadas, e 40% cromossomopatias. Foram registados 15 óbitos (3,4% de mortalidade) associados a prematuridade
e/ou baixo-peso ao nascer, cardiopatias congénitas críticas, outras malformações e anomalias cromossómicas.
Discussão: A prevalência de cardiopatias congénitas neste estudo (5/1000 nascimentos) foi inferior ao descrito noutros estudos
internacionais, não obstante uma distribuição por tipo de anomalia semelhante ao previamente reportado. Observaram-se assimetrias
regionais significativas que necessitam de mais investigação.
Conclusão: Este estudo é relevante para melhor conhecimento da realidade nacional e organização dos Cuidados de Saúde. É
importante uma maior adesão ao Registo Nacional de Anomalias Congénitas.
Palavras-chave: Cardiopatias Congénitas/epidemiologia; Portugal; Registos
Introduction: The prevalence at birth of congenital heart disease in Portugal is 8.3/1000 births; undetected critical congenital heart disease may result in adverse outcomes for the fetus/newborn infant. This study describes the reported cases of congenital heart disease in Portugal in 2015 regarding antenatal diagnosis, cardiac defect, and presence of other congenital anomalies/chromosomal abnormalities. These indicators are compared in live births and medical pregnancy terminations. Additionally, postnatal deaths were characterized. Material and methods: Congenital heart disease data derived from the 2015 Portuguese National Registry of Congenital Birth Defects were analyzed. The prevalence rates per 1000 births were assessed by the chi-square test of independence. Results: The prevalence of congenital heart disease in this study was 5/1000 live-births (339 live-births, 20% with critical defects). The most common defects were ventricular septal defect (38%), atrial septal defect (15%), aortic coarctation (7%), tetralogy of Fallot (7%) and pulmonary stenosis (5%). One third of the live births had antenatal diagnosis of congenital heart disease. In the live-births with critical congenital heart disease, 54% had antenatal diagnosis and 14% were diagnosed at birth. There were records of 84 pregnancy terminations; 49% had critical defects, 75% had non-cardiac congenital anomalies and 40% had chromosomal abnormalities. There were 15 postnatal deaths recorded (3.4% mortality rate), associated with prematurity/low birthweight, critical congenital heart disease, other non-cardiac congenital anomalies and chromosomal abnormalities. Discussion: The data analysis revealed a prevalence of congenital heart disease in this study of 5/1000 births (inferior to other international studies), with a distribution per type of anomaly similar to that reported in previously published work. There were significant regional differences that need further studying. Conclusion: These results are paramount to characterize the Portuguese scenario and improve Healthcare planning. It is important to improve reporting in the Portuguese National Registry of Congenital Birth Defects.
Introduction: The prevalence at birth of congenital heart disease in Portugal is 8.3/1000 births; undetected critical congenital heart disease may result in adverse outcomes for the fetus/newborn infant. This study describes the reported cases of congenital heart disease in Portugal in 2015 regarding antenatal diagnosis, cardiac defect, and presence of other congenital anomalies/chromosomal abnormalities. These indicators are compared in live births and medical pregnancy terminations. Additionally, postnatal deaths were characterized. Material and methods: Congenital heart disease data derived from the 2015 Portuguese National Registry of Congenital Birth Defects were analyzed. The prevalence rates per 1000 births were assessed by the chi-square test of independence. Results: The prevalence of congenital heart disease in this study was 5/1000 live-births (339 live-births, 20% with critical defects). The most common defects were ventricular septal defect (38%), atrial septal defect (15%), aortic coarctation (7%), tetralogy of Fallot (7%) and pulmonary stenosis (5%). One third of the live births had antenatal diagnosis of congenital heart disease. In the live-births with critical congenital heart disease, 54% had antenatal diagnosis and 14% were diagnosed at birth. There were records of 84 pregnancy terminations; 49% had critical defects, 75% had non-cardiac congenital anomalies and 40% had chromosomal abnormalities. There were 15 postnatal deaths recorded (3.4% mortality rate), associated with prematurity/low birthweight, critical congenital heart disease, other non-cardiac congenital anomalies and chromosomal abnormalities. Discussion: The data analysis revealed a prevalence of congenital heart disease in this study of 5/1000 births (inferior to other international studies), with a distribution per type of anomaly similar to that reported in previously published work. There were significant regional differences that need further studying. Conclusion: These results are paramount to characterize the Portuguese scenario and improve Healthcare planning. It is important to improve reporting in the Portuguese National Registry of Congenital Birth Defects.
Description
Abstract in Portuguese, English.
Keywords
Anomalias Congénitas Estados de Saúde e de Doença RENAC Registo Nacional de Anomalias Congénitas Observação em Saúde e Vigilância Registos Epidemiológicos Congenital Heart Defects Epidemiology Registries Portugal
Pedagogical Context
Citation
Acta Med Port. 2020 Jul 1;33(7-8):491-499. doi: 10.20344/amp.12111. Epub 2020 Jul 1.
Publisher
Ordem dos Médicos