Objective To investigate the prevalence and risk factors of neonatal congenital heart disease(CHD) in Hainan Province, and to obtain epidemiological information on neonatal CHD, so as to provide support for the establishment of a neonatal CHD prevention and treatment programme in Hainan Province. Methods A multicenter, multiple-ethnic, cross-sectional screening study was performed. A total of 117 005 neonates consecutively born at delivery institutions in 17 urban and rural regions in Hainan from January 1st to December 31st, 2020 were enrolled. Cases of CHD were identified using transcutaneous pulse oximetry(POX) combined with cardiac auscultation screening, echocardiography and follow-up. Results A total of 572 newborns(50.7% male) were diagnosed with CHD. The overall prevalence of CHD among live births in Hainan Province was 4.89‰, with the prevalence of insignificant, significant, severe and critical CHD being 2.13‰、2.25‰、0.28‰ and 0.23‰, respectively. The most common CHD is atrial septal defect(ASD) with a prevalence rate of 1.889‰. The proportion of preterm infants with significant CHD and critical CHD was significantly higher compared with newborns without CHD(χ2=4.088, 4.923, P<0.05), and the proportion of low birth weight infants with severe CHD and critical CHD was significantly higher compared with newborns without CHD(χ2＝24.284, 110.556, P<0.001). Among preterm infants with CHD, the total proportion of preterm infants with CHD at gestational age of 28 to 32 weeks was 60.3%(47/78), which was higher than that of preterm infants at gestational age of 33 to 36 weeks(39.7%(31/78)(χ2 =6.564, P<0.05). Among low birth weight children with CHD, the total proportion of those with birth weight of 1 500 -<2 000 g was 63.0%(29/46), higher than that of those with birth weight of 2 000 -<2 500 g(37.0%, 17/46)(χ2=6.261, P<0.05). The prevalence of CHD was significantly higher in some other ethnic groups(Miao, Hani and Yi) compared to the Chinese Han population(χ2=5.327, 8.233, 8.821, P<0.05). Correlation analysis showed that the prevalence of CHD in newborns was positively correlated with altitude(r=0.513, P<0.05). Conclusions POX combined with cardiac auscultation is suitable for CHD screening of newborns in remote areas. Premature birth, low birth weight and high altitudes are risk factors for CHD, which should be paid attention to during CHD screening.
Key words
congenital heart disease /
prevalence /
ethnic group /
neonates
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