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.
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.
Authors: Jennifer Zeitlin; Laust Mortensen; Marina Cuttini; Nicholas Lack; Jan Nijhuis; Gerald Haidinger; Béatrice Blondel; Ashna D Hindori-Mohangoo Journal: J Epidemiol Community Health Date: 2015-12-30 Impact factor: 3.710
Authors: Joan K Morris; Anna L Springett; Ruth Greenlees; Maria Loane; Marie-Claude Addor; Larraitz Arriola; Ingeborg Barisic; Jorieke E H Bergman; Melinda Csaky-Szunyogh; Carlos Dias; Elizabeth S Draper; Ester Garne; Miriam Gatt; Babak Khoshnood; Kari Klungsoyr; Catherine Lynch; Robert McDonnell; Vera Nelen; Amanda J Neville; Mary O'Mahony; Anna Pierini; Annette Queisser-Luft; Hanitra Randrianaivo; Judith Rankin; Anke Rissmann; Jennifer Kurinczuk; David Tucker; Christine Verellen-Dumoulin; Diana Wellesley; Helen Dolk Journal: PLoS One Date: 2018-04-05 Impact factor: 3.240
Authors: Shiliang Liu; K S Joseph; Wei Luo; Juan Andrés León; Sarka Lisonkova; Michiel Van den Hof; Jane Evans; Ken Lim; Julian Little; Reg Sauve; Michael S Kramer Journal: Circulation Date: 2016-08-30 Impact factor: 29.690
Authors: José Luis Torres-Cosme; Constanza Rolón-Porras; Mónica Aguinaga-Ríos; Pedro Manuel Acosta-Granado; Enrique Reyes-Muñoz; Teresa Murguía-Peniche Journal: PLoS One Date: 2016-03-03 Impact factor: 3.240