Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T13:05:36.286Z Has data issue: false hasContentIssue false

Descriptive epidemiology of membranous and muscular ventricular septal defects in the Baltimore-Washington Infant Study

Published online by Cambridge University Press:  19 August 2008

David A. Lewis
Affiliation:
From the Departments of Cardiology, Children‘s National Medical Center, and the Baltimore-Washington Infant Study Group, Baltimore
Christopher A. Loffredo
Affiliation:
Epidemiology and Preventive Medicine, University of Maryland School of Medicine, and the Baltimore-Washington Infant Study Group, Baltimore
Adolfo Correa-Villaseñor
Affiliation:
Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University, and the Baltimore-Washington Infant Study Group, Baltimore
P. David Wilson
Affiliation:
Epidemiology and Preventive Medicine, University of Maryland School of Medicine, and the Baltimore-Washington Infant Study Group, Baltimore
Gerard R. Martin*
Affiliation:
From the Departments of Cardiology, Children‘s National Medical Center, and the Baltimore-Washington Infant Study Group, Baltimore
*
Dr. Gerard R. Martin, Children‘s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010-2970, USA. Tel. 202-884-2020; Fax. 202-884-5700.

Abstract

Although ventricular septal defect is the most common form of congenital heart disease, its epidemiology is not completely understood. The Baltimore-Washington Infant Study, a case-control study of congenital cardiovascular malformations, enrolled 4,390 case infants during the study period 1981–1989. Ventricular septal defect, the most common malformation, was present in 1,465 (33%) of affected infants. The purpose of this report was to describe the epidemiological characteristics of membranous and muscular ventricular septal defects, the most common types of ventricular septal defects. Membranous ventricular septal defects (n=895) and muscular ventricular septal defects (n=429) accounted for 90% of all ventricular defects. During the study, prevalence increased from 0.9 to 2.1 /1000 live births. Associated non-cardiac defects, such as chromosomal defects, genetic syndromes, and defects of other organs were more common among infants with ventricular septal defect than among control infants, and more common among infants with membranous ventricular defect (20.8%) than among those with muscular defects (7.5%). Infants with ventricular septal defects and non-cardiac defects had increased mortality in comparison to infants with isolated ventricular septal defects or controls. Epidemiological information derived from population-based studies provide valuable data for counseling families and may allow for examination of etiologic factors.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Keith, JD. Prevalence, incidence and epidemiology. In: Keith, JD, Rowe, RD, Vlad, P (eds). Heart Disease in Infancy and Childhood, third edition. MacMillan, New York, 1978, pp 413.Google Scholar
2.Graham, TP, Bender, HW, Spach, MS. Ventricular septal defect. In: Adams, FH, Emmanouilides, GC, Riemenschneider, TA (eds). Moss‘ Heart Disease in Infants, Children, and Adolescents, fourth edition. Williams and Wilkins, Baltimore, 1989, pp 189208.Google Scholar
3.Fyler, DC.Report of the New England regional infant cardiac program. Pediatrics 1980; 65: 375461.Google Scholar
4.Ferencz, C, Rubin, JD, McCarter, RJ, Brenner, JI, Neill, CA, Perry, LW, Hepner, SI, Downing, JW.Congenital heart disease: Prevalence at live birth. Am J Epidemiology 1985; 121: 3136.CrossRefGoogle Scholar
5.Fyler, DC. Ventricular septal defect. In: Fyler, DC (ed). Nadas' Pediatric Cardiology. Hanley and Belfus, Inc., Philadelphia, 1992, pp 435457.Google Scholar
6.Hoffman, JIE, Christianson, R.Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol 1978; 42: 641647.CrossRefGoogle Scholar
7.Pinkley, K, Stoesz, PA.Current trends: ventricular septal defect. MMWR 1981; 30: 609610.Google Scholar
8.Tikkanen, J, Heinonen, OP.Risk factor of ventricular septal defect in Finland. Public Health 1991; 105: 99112.CrossRefGoogle ScholarPubMed
9.Layde, PJ, Dooley, K, Erickson, JD, Edmonds, LD.Is there an epidemic of ventricular septal defects in the USA ? Lancet 1980; 1: 407408.Google Scholar
10.Grabitz, RG, Joffres, MR, Collins-Nakai, RL.Congenital heart disease: Incidence in the first year of life: The Alberta Heritage Pediatric Cardiology Program. Am J Epidemiol 1988; 128: 381388.CrossRefGoogle ScholarPubMed
11.Fixler, DE, Pastor, P, Chamberlin, M, Sigman, E, Eifler, CW.Trends in congenital heart disease in Dallas county births 1971–1984. Circulation 1990; 81: 137142.CrossRefGoogle ScholarPubMed
12.Cook, D, Izukawa, T, Rowe, RD.An epidemic of ventricular septal defects. Lancet 1980; 6: 12971298.CrossRefGoogle Scholar
13.Spooner, EW, Hook, EB, Farina, MA, Shaher, RM.Evaluation of a temporal increase in ventricular septal defects: estimated prevalence and severity in northeastern New York, 1970–1983. Teratology 1988; 37: 2128.CrossRefGoogle ScholarPubMed
14.Newman, TB.Etiology of ventricular septal defect: an epide-miologic approach. Pediatrics 1985; 76: 741749.CrossRefGoogle ScholarPubMed
15.Martin, GR, Perry, LW, Ferencz, C. Increased prevalence of ventricular septal defect: epidemic or improved diagnosis? Pediatrics 1989; 83: 200203.CrossRefGoogle ScholarPubMed
16.Wilson, PD, Correa-Villasenor, A, Loffredo, CA, Ferencz, C and the Baltimore-Washington Infant Study Group. Temporal trends in prevalence of cardiovascular malformations in Maryland and the District of Columbia. Epidemiology 1993; 4: 259265.CrossRefGoogle ScholarPubMed
17.Kidd, L, Driscoll, DJ, Gersony, WM, Hayes, CJ, Keane, JF, O'Fallon, M, Pieroni, DR, Wolfe, RR, Weidman, WH.Second natural history study of congenital heart disease: Results of treatment of patients with ventricular septal defects. Circulation 1993; 87: 138151.Google ScholarPubMed
18.Gersony, WM, Hayes, CJ, Driscoll, DJ, Keane, JF, Kidd, L, O'Fallon, M, Pieroni, DR, Wolfe, RR, Weidman, WH.Second natural history study of congenital heart disease: Quality of life of patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect. Circulation 1993; 87 (Suppl I): 152165.Google ScholarPubMed
19.Driscoll, DJ, Wolfe, RR, Gersony, WM, Hayes, CJ, Keane, JF, Kidd, L, O'Fallon, M, Pieroni, DR, Weidman, WH.Cardiores-piratory response to exercise of patients with aortic stenosis, pulmonary stenosis, and ventricular septal defect. Circulation 1993; 87(Suppl I): 11021113.Google Scholar
20.Driscoll, DJ, Michels, VV, Gersony, WM, Hayes, CJ, Keane, JF, Kidd, L, Pieroni, DR, Rings, LJ, Wolfe, RR, Weidman, WH. Occurrence risk for congenital heart disease in relatives of patients with aortic stenosis, pulmonary stenosis, and ventricular septal defect. Circulation 1993; 87(Suppl I): 11141120.Google ScholarPubMed
21.Ferencz, C, Rubin, JDResearch design, resources and methods. In: Ferencz, C, Rubin, JD, Loffredo, CA, Magee, CA (eds). Perspectives in Pediatric Cardiology. Volume 4, Epidemiology of Congenital Heart Disease The Baltimore-Washington Infant Study 1981–1989. Futura Publishing Company, Mount Kisco, NY, 1993, pp 1732.Google Scholar
22.Perry, LW, Neill, CA, Ferencz, C, Rubin, JD, Loffredo, CA. Infants with congenital heart disease: the cases. In: Ferencz, C, Rubin, JD, Loffredo, CA, Magee, CA (eds). Perspectives in Pediatric Cardiology. Volume 4, Epidemiology of Congenital Heart Disease—The Baltimore-Washington Infant Study 1981–1989. Futura Publishing Company, Mount Kisco, NY, 1993, pp 3362.Google Scholar
23.Rubin, JD, Ferencz, C. Study subjects: participant rates and representativeness. In: Ferencz, C, Rubin, JD, Loffredo, CA, Magee, CA (eds). Perspectives in Pediatric Cardiology. Volume 4, Epidemiology of Congenital Heart Disease The Baltimore-Washington Infant Study 1981–1989. Futura Publishing Company, Mount Kisco, NY, 1993, pp 6373.Google Scholar
24.International Society of Cardiology. Classification of Heart Disease in Childhood. VRB Offsetdrukkerij, Groningen, 1970.Google Scholar
25.Hiriashi, S, Agata, Y, Nowatari, M, Oguchi, K, Misawa, H, Hirota, H, Fujino, N, Horiguchi, Y, Yashiro, K, Nakae, S.Incidence and natural course of trabecular ventricular septal defect: Two-dimensional echocardiography and color flow Doppler flow imaging study. J Pediatr 1992; 120: 409415.CrossRefGoogle Scholar
26.Hagler, DJ, Edwards, WD, Seward, JA, Tajik, AJ.Standardized nomenclature of the ventricular septum and ventricular septal defects, with application for 2-D echocardiography. Mayo Clin Proc 1985; 60: 741742.CrossRefGoogle Scholar
27.SAS Institute, Inc. SAS/STAT User‘s Guide, Vols. 1 and 2, Version 6. SAS Institute, Gary, NC, 1990.Google Scholar
28.Wegman, ME.Annual summary of vital statistics-1992. Pediatrics 1993; 92: 743754.CrossRefGoogle ScholarPubMed
29.Rubin, JD, Ferencz, C.Subsequent pregnancy in mothers of infants with congenital heart disease. Pediatrics 1985; 76: 371374.CrossRefGoogle ScholarPubMed
30.Mitchell, SC, Korones, SB, Berendes, HW.Congenital heart disease in 56,109 births. Circulation 1971; 43: 323332.CrossRefGoogle Scholar
31.Correa-Villasenor, A, McCarter, R, Dowling, J, Ferencz, C, the Baltimore-Washington Infant Study Group. White-Black differences in cardiovascular malformations in infancy and socioeconomic factors. Am J Epidemiol 1991; 134: 392402.CrossRefGoogle ScholarPubMed
32.Samanek, M.Boy:girl ratio in children born with different forms of cardiac malformation: A population-based study. Pediatr Cardiol 1994; 15: 5357.CrossRefGoogle ScholarPubMed
33.Boughman, J, Berg, KA, Astemborski, JA, Clark, EB, McCarter, RJ, Rubin, JD, Ferencz, C.Familial risks of congenital heart defect assessed in a population-based epidemiologic study. Am J Med Genet 1987; 26: 839849.CrossRefGoogle Scholar
34.Boughman, JA, Neill, CA, Ferencz, C, Loffredo, CA. The genetics of congenital heart disease. In: Ferencz, C, Rubin, JD, Loffredo, CA, Magee, CA (eds). Perspectives in Pediatric Cardiology. Volume 4, pidemiology of Congenital Heart Disease The Baltimore-Washington Infant Study 1981–1989. Futura Publishing Company, Mount Kisco, NY, 1993, pp 123168.Google Scholar
35.Brenner, WE, Edelman, DA, Hendricks, CH.A standard of fetal growth for the United States of America. Am J Obstet Gynecol 1976; 126: 555564.CrossRefGoogle ScholarPubMed
36.Fixler, DE, Pastor, P, Sigman, E, Eifler, CW.Ethnicity and socioeconomic status: Impact on the diagnosis of congenital heart disease. J Amer Coll Cardiol 1993; 21: 17221726.CrossRefGoogle ScholarPubMed