epidemiología y registro de las cardiopatías congénitas en costa rica epidemiology and registry of congenital heart disease in costa rica

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ID: 192911
2011
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Abstract
OBJETIVO: Caracterizar la población de niños que nacen con cardiopatías congénitas (CC) en Costa Rica y evaluar sus procesos de registro. MÉTODOS: Estudio observacional exploratorio que incluyó a todos los niños con CC diagnosticadas en el Hospital Nacional de Niños entre el 1 de mayo de 2006 y el 1 de mayo de 2007. Tomando en cuenta los niños menores de 1 año y su respectiva cohorte de nacimientos, se estimaron prevalencias con intervalos de confianza de 95% (IC95%) según sexo, tipo de cardiopatía, edad al diagnóstico, edad materna, residencia habitual y malformaciones extracardiacas asociadas. Se compararon los datos con el Centro de Registro de Enfermedades Congénitas (CREC). RESULTADOS: Durante el período estudiado se diagnosticaron 534 casos con CC. Los casos en menores de 1 año fueron 473 dentro de una cohorte de nacimientos de 77 140 -prevalencia de 0,6% (IC95%: 0,5-0,7). Con base en datos del CREC, se demostró que al nacimiento no se detectan 71% de los casos. La edad promedio al diagnóstico en niños menores de 1 año fue de 46,6 días. No hubo diferencias por sexo. La prevalencia de CC en hijos de madres de 35 años o más fue significativamente mayor, aunque al excluir las cromosomopatías este riesgo perdió su significancia estadística. Las provincias del país con puertos marítimos fueron las de mayor riesgo en hijos de madres adolescentes. Las CC más frecuentes fueron los defectos del tabique interventricular e interauricular, persistencia del conducto arterioso, estenosis valvular pulmonar, defectos del tabique aurículo ventricular, coartación de aorta y tetralogía de Fallot. El 34% de las CC fueron múltiples, 11,2% se asociaron a cromosomopatías y 19% tenían malformaciones congénitas asociadas. CONCLUSIONES: La prevalencia de CC en Costa Rica está dentro del rango informado a nivel mundial. Se halló que en el CREC había un importante subregistro de CC debido principalmente a los criterios de edad aplicados. Los resultados sugieren que la edad materna (menores de 20 años y mayores de 34 años) es un factor asociado a la ocurrencia de CC.
OBJECTIVE: Characterize the population of children born with congenital heart disease (CHD) in Costa Rica and evaluate the country's registry processes. METHODS: Exploratory observational study that included all children with CHD diagnosed at the National Children's Hospital between 1 May 2006 and 1 May 2007. Considering children under 1 year of age and their respective birth cohort, prevalence was estimated by sex, type of heart disease, age at diagnosis, maternal age, habitual residence, and associated extracardiac malformations, with 95% confidence intervals (95% CI). The data was compared with those of the Congenital Disease Registry Center (CREC). RESULTS: During the period studied, 534 cases with CHD were diagnosed. There were 473 cases in children under 1 year of age in a birth cohort of 77 140 children. Prevalence was 0.6% (95% CI: 0.5-0.7). Based on CREC data, it was demonstrated that 71% of the cases were not detected at birth. The average age of diagnosis in infants under 1 year of age was 46.6 days. There were no differences by sex. Prevalence of CHD in children of mothers aged 35 years or over was significantly higher. However, when chromosomal abnormalities were excluded, the risk was no longer statistically significant. The provinces in the country with maritime ports were the areas with the highest risk in children of adolescent mothers. The most common CHDs were ventricular and atrial septal defects, patent ductus arteriosus, pulmonary valve stenosis, atrioventricular septal defects, coarctation of the aorta, and tetralogy of Fallot. Thirtyfour percent of the cases of CHD were multiple, 11.2% were associated with chromosomal abnormalities, and 19% had associated congenital malformations. CONCLUSIONS: CHD prevalence in Costa Rica is within the range reported globally. Significant underreporting of CHD was found in the CREC, primarily due to the age criteria applied. The results suggest that maternal age (under 20 and over 34) is a factor associated with CHD.
Reference Key
benavides-lara2011revistaepidemiologa Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Adriana Benavides-Lara;Jorge Enrique Faerron Ángel;Lila Umaña Solís;Juan José Romero Zúñiga
Journal communications on pure and applied analysis
Year 2011
DOI
DOI not found
URL
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011000700005
Keywords
child health infant recién nacido costa rica lactante heart defects newborn congenital tropical medicinepublic aspects of medicine

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