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Spectrum of paediatric cardiac diseases: a study of 15,066 children undergoing cardiac intervention at a tertiary care centre in India with special emphasis on gender

Published online by Cambridge University Press:  01 October 2010

Viralam S. Kiran ,
Parrimala P. Nath  and
Sunita Maheshwari
Viralam S. Kiran*
Affiliation:
Department of Paediatric Cardiology, Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, India
Parrimala P. Nath
Affiliation:
Department of Paediatric Cardiology, Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, India
Sunita Maheshwari
Affiliation:
Department of Paediatric Cardiology, Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, India
*
Correspondence to: Dr V. S. Kiran, Department of Paediatric Cardiology, Narayana Hrudayalaya Institute of Cardiac Sciences, No. 258/1, Bommasandra Industrial area, Anekal Taluk, Bangalore 560099, India. Tel: +91 80 27835000; Fax: +91 80 27832648; E-mail: drkiranvs@gmail.com
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Abstract

Objectives

To analyse the relative frequency and gender ratios in the procedures (both surgical and catheter-based interventions) performed for cardiac diseases in Indian children.

Background

Not many studies are available in the developing countries with regard to the prevalence, relative frequency, or gender distribution of cardiac diseases in children. As universal newborn screening is not carried out for congenital cardiac diseases, the statistics are difficult to ascertain. Do female and male children with cardiac disease get equal parental preference in terms of surgical correction and catheter interventions in India? This question is also unanswered.

Methods

Analysis of 15,066 consecutive Indian children aged <18 years who were operated upon or had catheter intervention at a single tertiary care centre. Relative frequency and male/female ratios of cardiac lesions in these children were determined and compared with the studies in literature.

Results

Overall male/female ratio in the study was 1.4:1. Ventricular septal defect was the most common lesion (24.2%) with male/female ratio of 1.5:1, followed by tetralogy of Fallot (18.7%, 1.6:1), atrial septal defect (14.4%, 0.9:1) and so on. Male children dominated the total number of procedures performed.

Conclusion

In most of the individual cardiac lesions, the relative frequency was different from that of international studies. The gender ratio for the majority of the individual type of cardiac problems was different from that of international references. These findings may suggest a preference for the male child in the treatment of cardiac diseases in India, which could possibly be related to social causes.

Keywords

Prevalenceventricular septal defecttetralogy of Fallotsocial issues
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 1 , February 2011 , pp. 19 - 25
Copyright
Copyright © Cambridge University Press 2010

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References

1. Mitchell, SC, Korones, SB, Berendes, NW. Congenital heart disease in 56,109 births: incidence and natural history. Circulation 1971; 37: 323–332.CrossRefGoogle Scholar
2. Boneva, RS, Botto, LD, Moore, CA, et al. Mortality associated with congenital heart defects in the United States: trends and racial disparities, 1979–1997. Circulation 2001; 103: 2376–2381.CrossRefGoogle ScholarPubMed
3. Alabdulgader, A. Congenital heart disease in 740 subjects: epidemiological aspects. Ann Trop Paediatr 2001; 21: 111–118.CrossRefGoogle ScholarPubMed
4. Kuehl, KS, Loffredo, CA, Ferencz, C. Failure to diagnose congenital heart disease in infancy. Pediatrics 1999; 103: 743–747.CrossRefGoogle ScholarPubMed
5. Pradat, P, Francannet, C, Harris, JA, Robert, E. The epidemiology of cardiovascular defects, part I: a study based on data from three large registries of congenital malformations. Paediatr Cardiol 2003; 24: 195–221.CrossRefGoogle Scholar
6. Ferencz, C, Rubin, JD, McCarter, RJ, et al. Congenital heart disease: prevalence at livebirth: the Baltimore–Washington infant study. Am J Epidemiol 1985; 121: 31–36.CrossRefGoogle ScholarPubMed
7. van den Bosch, WJ, Huygen, FJ, van den Hoogen, HJ, van Weel, C. Morbidity in early childhood, sex differences, birth order and social class. Scand J Prim Health Care 1992; 10: 118–123.CrossRefGoogle ScholarPubMed
8. van den Bosch, WJ, Huygen, FJ, van den Hoogen, HJ, van Weel, C. Morbidity in early childhood: differences between girls and boys under 10 years old. Br J Gen Pract 1992; 42: 366–369.Google ScholarPubMed
9. Beeson, PB. Age and sex associations of 40 autoimmune diseases. Am J Med 1994; 96: 457–462.CrossRefGoogle ScholarPubMed
10. McCabe, LL, McCabe, R. Newborn screening as a model for population screening. Mol Genet Metab 2002; 75: 299–307.CrossRefGoogle Scholar
11. Samánek, M. Boy:girl ratio in children born with different forms of cardiac malformation: a population-based study. Paediatr Cardiol 1994; 15: 53–57.CrossRefGoogle ScholarPubMed
12. Miyague, NI, Cardoso, SM, Meyer, F, et al. Epidemiological study of congenital heart defects in children and adolescents. Analysis of 4,538 cases. Arq Bras Cardiol 2003; 80: 274–278.CrossRefGoogle ScholarPubMed
13. Khalil, A, Aggarwal, R, Thirupuram, S, Arora, R. Incidence of congenital heart disease among hospital live births in India. Indian Pediatr 1994; 31: 519–527.Google ScholarPubMed
14. Hoffman, HE. Congenital heart disease: incidence and inheritance. Pediatr Clin North Am 1990; 37: 25–43.CrossRefGoogle ScholarPubMed
15. Hoffman, JI, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
16. Mészáros, M, Nagy, A, Krasznai, G, Czeizel, A. Birth prevalence of congenital cardiovascular malformation in Hungary. Acta Paediatr Acad Sci Hung 1980; 21: 221–225.Google ScholarPubMed
17. Xue-yong, Y, Xiao-feng, L, Xiao-dong, L, Ying-long, L. Incidence of congenital heart disease in Beijing, China. Chin Med J 2009; 122: 1128–1132.Google Scholar
18. Fyler, DC. Report of the New England Regional Infant Cardiac Program. Pediatrics 1980; 65: 375–461.Google Scholar
19. Botto, LD, Correa, A, Erickson, JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics 2001; 107: e32.CrossRefGoogle ScholarPubMed
20. Anderson, RC. Congenital heart malformations in North American Indian children. Pediatrics 1977; 59: 121–123.Google ScholarPubMed
21. Calzolari, E, Garani, G, Cocchi, G, et al. Congenital heart defects: 15 years of experience of the Emilia–Romagna Registry (Italy). Eur J Epidemiol 2003; 18: 773–780.CrossRefGoogle ScholarPubMed
22. Dilber, D, Malcic, I. Spectrum of congenital heart defects in Croatia. Eur J Paediatr 2010; 169: 543–550.CrossRefGoogle Scholar
23. Samánek, M, Vorísková, M. Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Paediatr Cardiol 1999; 20: 411–417.CrossRefGoogle ScholarPubMed
24. Bosi, G, Scorrano, M, Tosato, G, Forini, E, Chakrokh, R. The Italian Multicentric Study on Epidemiology of Congenital Heart Disease: first step of the analysis. Working Party of the Italian Society of Paediatric Cardiology. Cardiol Young 1999; 9: 291–299.CrossRefGoogle Scholar
25. Patton, C, Hey, E. How effectively can clinical examination pick up congenital heart disease at birth? Arch Dis Child Fetal Neonatal Ed 2006; 91: F263–F267.CrossRefGoogle ScholarPubMed
26. Kothari, SS. Pediatric cardiac care for the economically disadvantaged in India: problems and prospects. Ann Pediatr Card 2009; 2: 95–98.CrossRefGoogle Scholar
27. Maheshwari, S, Kiran, VS. Cardiac care for the economically challenged: what are the options? Ann Pediatr Card 2009; 2: 91–94.CrossRefGoogle ScholarPubMed
28. Somerville, J. The Denolin lecture: the woman with congenital heart disease. Eur Heart J 1998; 19: 1766–1775.CrossRefGoogle ScholarPubMed
29. Pradat, P. Epidemiology of major congenital heart defects in Sweden, 1981–1986. J Epidemiol Community Health 1992; 46: 211–215.CrossRefGoogle Scholar
30. Iyer, A, Sen, G, George, A. The dynamics of gender and class in access to health care: evidence from rural Karnataka. India Int J Health Serv 2007; 37: 537–554.CrossRefGoogle ScholarPubMed
31. Fikree, FF, Pasha, O. Role of gender in health disparity: the South Asian context. BMJ 2004; 328: 823–826.CrossRefGoogle ScholarPubMed