The Incidence and Life Expectation of Children With Congenital Heart Disease

An acceptable estimate of the incidence of congenital heart disease in the general population of births is not yet available. Observations recorded at birth on series of consecutive births have given figures that are clearly much too low, which is scarcely surprising in view of the uncertainty of diagnosis in the newborn. Malpas (1937) found only 10 patients with heart defects among 13,964 births (0-7 per thousand) and DePorte and Parkhurst (1945) noted 142 in 300,795 births (0 5 per thousand). Estimates of incidence in patients examined post mortem (reported by Leech, 1935; and Potter, 1940; among many others) or in patients admitted to hospitals (Roberts, 1937; Thordarson, 1947) vary widely, and are equally unsatisfactory as indices of incidence in all births. Perhaps the most reliable data have been derived from examination of school children, for whom Sampson et al. (1938), Rauh (1939) and Weiss (1941) gave estimates between 0d14 and 0-16 per thousand. These figures are of course unacceptable as an expression of incidence in the general population of births. Data recorded in the Registrar-General's Statistical Review of England and Wales indicate that the majority of deaths attributed to congenital heart disease occur before the end of the first year of life, and even when allowance is made for errors in certification it can hardly be doubted that early mortality is very high.