Rationale Congenital heart disease (CHD) constitutes a significant proportion of birth defects and is a leading cause of mortality. Current literature regarding the local prevalence of CHD and timeliness of diagnosis is not available.
Objective This study aims to determine the live birth prevalence of CHDs in Singapore General Hospital (SGH), the antenatal diagnosis rate, and the proportion of CHD patients diagnosed after discharge from the SGH neonatal unit.
Methods This was a retrospective observational study. All live-births at SGH from January 2003 to December 2012 diagnosed with CHDs according to the hospital’s birth defect register were included. All patients born in SGH within the same time-frame who were diagnosed with CHD in KK Women’s and Children’s Hospital (the largest Paediatric tertiary hospital locally) after discharge from SGH were also included.
Results From Jan 2003 to Dec 2012, out of 16,171 live-births at SGH, 259 patients were diagnosed with CHD. After excluding 63 cases of PDA, 44 cases of PFO and 2 cases of PFC, 150 patients were left for analysis. Overall live-birth prevalence was 9.3 per 1000 live-births.
Prevalence of CHD as outlined in Table 1.
Overall antenatal detection rate was 5.3%
There was significant variation in antenatal detection rate among CHDs. Whilst antenatal detection of certain life-threatening CHDs (hypoplastic left heart, transposition of great arteries and pulmonary atresia) was high, that for TAPVD and coarctation of aorta was much poorer.
A significant proportion of CHD was diagnosed after being discharged from SGH (28.7%)-table 3. One with coarctation presented in extremis in KKH Children Emergency after discharge from SGH.