Mortality Trends Related to Congenital Heart Defects in United States: a CDC WONDER analysis

BACKGROUND Congenital heart defects (CHD) are diagnosed in 1/100 live births in the United States. Advances in medical care have reduced CHD-related mortality, but disparities remain across demographic and geographic groups. METHODS Death certificates from the CDC WONDER database were analyzed from 1999 to 2020 in children aged < 1–14 years. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated and stratified by race, gender, place of death, and census region. Joinpoint regression analysis was used to determine annual percent changes (APC) and identify trends in mortality rates. RESULTS A total of 49,890 deaths occurred due to CHD from 1999–2020. The AAMR declined from 4.748 in 1999 to 3.473 in 2010 (APC − 2.55*; 95%CI:-4.57 to -2.08) and from 3.473 in 2010 to 2.987 in 2020 (APC − 1.25; 95% CI: -1.85 to 1.23). Males had a higher overall AAMR (3.81) than females (3.56). Non-Hispanic Black had the highest AAMR (4.919), while Non-Hispanic Asian had the lowest (2.759). The South showed the highest AAMR (3.953) and the Northwest the lowest (2.823). The majority of deaths occurred in medical facilities (91%), followed by decedents' homes (7.3%), hospice facilities (0.4%), and nursing homes/long-term care (0.2%). Among CHD subtypes, VSD-related mortality had the highest AAMR (0.245) while Malformation of coronary vessels the lowest (0.039). CONCLUSION CHD-related AAMR fell from 1999 to 2020 with a slower decline between 2010 and 2020. The data showed that the AAMR was consistently higher in males, NH Black, and in Southern and Midwestern regions, with most deaths occurring in medical facilities.