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Recent decrease in the prevalence of congenital heart defects in Europe

Recent decrease in the prevalence of congenital heart defects in Europe
Recent decrease in the prevalence of congenital heart defects in Europe
Objectives: to examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification.

Study design: we used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births. We estimated trends for all CHDs combined and separately for 3 severity groups using random-effects Poisson regression models with splines.

Results: we found that the total prevalence of CHDs increased during the 1990s and the early 2000s until 2004 and decreased thereafter. We found essentially no trend in total prevalence of the most severe group (group I), whereas the prevalence of severity group II increased until about 2000 and decreased thereafter. Trends for severity group III (the most prevalent group) paralleled those for all CHDs combined.

Conclusions: the prevalence of CHDs decreased in recent years in Europe in the absence of a policy for mandatory folic acid fortification. One possible explanation for this decrease may be an as-yet-undocumented increase in folic acid intake of women in Europe following recommendations for folic acid supplementation and/or voluntary fortification. However, alternative hypotheses, including reductions in risk factors of CHDs (eg, maternal smoking) and improved management of maternal chronic health conditions (eg, diabetes), must also be considered for explaining the observed decrease in the prevalence of CHDs in Europe or elsewhere
0022-3476
108-113
Khoshnood, Babak
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Loane, Maria
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Garne, Ester
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Addor, Marie-Claude
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Arriola, Larraitz
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Bakker, Marian
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Barisic, Ingeborg
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Bianca, Sebastiano
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Boyd, Patricia
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Calzolari, Elisa
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Doray, Berenice
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Draper, Elizabeth
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Gatt, Miriam
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Haeusler, Martin
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Melve, Kari Klungsoyr
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Latos-Bielenska, Anna
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McDonnell, Bob
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Mullaney, Carmel
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Nelen, Vera
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O'Mahony, Mary
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Pierini, Anna
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Queisser-Luft, Annette
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Randrianaivo, Hanitra
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Rankin, Judith
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Rissmann, Anke
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Salvador, Joaquin
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Tucker, David
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Verellen-Dumoulin, Christine
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Wellesley, Diana
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Zymak-Zakutnya, Natalya
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Dolk, Helen
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Khoshnood, Babak
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Loane, Maria
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Garne, Ester
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Addor, Marie-Claude
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Arriola, Larraitz
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Bakker, Marian
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Barisic, Ingeborg
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Bianca, Sebastiano
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Boyd, Patricia
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Calzolari, Elisa
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Doray, Berenice
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Draper, Elizabeth
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Gatt, Miriam
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Haeusler, Martin
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Melve, Kari Klungsoyr
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Latos-Bielenska, Anna
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McDonnell, Bob
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Mullaney, Carmel
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Nelen, Vera
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O'Mahony, Mary
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Pierini, Anna
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Queisser-Luft, Annette
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Randrianaivo, Hanitra
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Rankin, Judith
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Rissmann, Anke
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Salvador, Joaquin
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Tucker, David
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Verellen-Dumoulin, Christine
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Wellesley, Diana
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Zymak-Zakutnya, Natalya
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Dolk, Helen
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Khoshnood, Babak, Loane, Maria, Garne, Ester, Addor, Marie-Claude, Arriola, Larraitz, Bakker, Marian, Barisic, Ingeborg, Bianca, Sebastiano, Boyd, Patricia, Calzolari, Elisa, Doray, Berenice, Draper, Elizabeth, Gatt, Miriam, Haeusler, Martin, Melve, Kari Klungsoyr, Latos-Bielenska, Anna, McDonnell, Bob, Mullaney, Carmel, Nelen, Vera, O'Mahony, Mary, Pierini, Anna, Queisser-Luft, Annette, Randrianaivo, Hanitra, Rankin, Judith, Rissmann, Anke, Salvador, Joaquin, Tucker, David, Verellen-Dumoulin, Christine, Wellesley, Diana, Zymak-Zakutnya, Natalya and Dolk, Helen (2013) Recent decrease in the prevalence of congenital heart defects in Europe. Journal of Pediatrics, 162 (1), 108-113. (doi:10.1016/j.jpeds.2012.06.035). (PMID:22835879)

Record type: Article

Abstract

Objectives: to examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification.

Study design: we used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births. We estimated trends for all CHDs combined and separately for 3 severity groups using random-effects Poisson regression models with splines.

Results: we found that the total prevalence of CHDs increased during the 1990s and the early 2000s until 2004 and decreased thereafter. We found essentially no trend in total prevalence of the most severe group (group I), whereas the prevalence of severity group II increased until about 2000 and decreased thereafter. Trends for severity group III (the most prevalent group) paralleled those for all CHDs combined.

Conclusions: the prevalence of CHDs decreased in recent years in Europe in the absence of a policy for mandatory folic acid fortification. One possible explanation for this decrease may be an as-yet-undocumented increase in folic acid intake of women in Europe following recommendations for folic acid supplementation and/or voluntary fortification. However, alternative hypotheses, including reductions in risk factors of CHDs (eg, maternal smoking) and improved management of maternal chronic health conditions (eg, diabetes), must also be considered for explaining the observed decrease in the prevalence of CHDs in Europe or elsewhere

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More information

e-pub ahead of print date: 24 July 2012
Published date: January 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 341949
URI: http://eprints.soton.ac.uk/id/eprint/341949
ISSN: 0022-3476
PURE UUID: ab0e9837-8dec-486e-9f2d-65a204505b25

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Date deposited: 08 Aug 2012 14:11
Last modified: 22 Jul 2022 18:11

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Contributors

Author: Babak Khoshnood
Author: Maria Loane
Author: Ester Garne
Author: Marie-Claude Addor
Author: Larraitz Arriola
Author: Marian Bakker
Author: Ingeborg Barisic
Author: Sebastiano Bianca
Author: Patricia Boyd
Author: Elisa Calzolari
Author: Berenice Doray
Author: Elizabeth Draper
Author: Miriam Gatt
Author: Martin Haeusler
Author: Kari Klungsoyr Melve
Author: Anna Latos-Bielenska
Author: Bob McDonnell
Author: Carmel Mullaney
Author: Vera Nelen
Author: Mary O'Mahony
Author: Anna Pierini
Author: Annette Queisser-Luft
Author: Hanitra Randrianaivo
Author: Judith Rankin
Author: Anke Rissmann
Author: Joaquin Salvador
Author: David Tucker
Author: Christine Verellen-Dumoulin
Author: Diana Wellesley
Author: Natalya Zymak-Zakutnya
Author: Helen Dolk

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