Incidence and Risk Factors of Congenital Heart Disease in Qingdao: A Prospective Census Study

Background The incidence of congenital heart disease (CHD) were greatly inconsistent among many studies with a range from 4/1,000 to 50/1,000. A large prospective population study was performed to investigate the incidence and find risk factors of congenital heart disease (CHD) during fetal and neonatal period.Methods A prospective cohort study was conducted in Qingdao, China, from August 1, 2018 to April 30, 2019. All local registered pregnant were continuously investigated and followed from the first trimester to delivery, collecting the characteristics of pregnant and their newborns. A Poisson regression model was applied to assess the association between CHD and possible risk factors.Results The incidence of fetal CHD and neonatal CHD are 15.84 per 1000 fetuses and 7.32 per 1000 live births, respectively. Results from Poisson regression indicated that, countryside (0.821; 95% CI, 0.730-0.920) and first gestation (0.890; 95% CI, 0.813-0.975) was negatively associated with CHD. However, paternal factors such as multi-fetal infants (RR: 1.631, 95% confidence interval, CI: 1.276-2.036), greater than high school degree (1.390; 95% CI, 1.129-1.701), illness in 1st trimester (1.214; 95% CI, 1.080-1.359), family history of CHD (2.480; 95% CI, 1.362-3.967), and having a baby with birth defect before (1.780; 95% CI, 1.300-2.345) were positive associated with CHD.Conclusion The incidence of CHD in Qingdao was similar to existing research. Compared with neonate, the incidence of CHD is higher in fetal. Multi-fetal infants, greater than high school degree, illness in 1st trimester, family history of CHD and having a baby with birth defect before were correlated with an increased risk of CHD. This prospective study would provide great implications for on CHD intervention.