Key result
Global congenital heart disease mortality in infants under 1 year decreased by 54.58% from 1990 to 2021, dropping from 369,851 to 167,985 deaths.
Why the study?
Previous congenital heart disease estimates were constrained by limited data sources, narrow geographic focus, and a lack of specific assessment of infants younger than 1 year.
Cross-Sectional
Effect estimate: -54.58% (95% CI -65.22 to -23.77)
Absolute Event Rate: 167985.02% vs 369851.15%
Global mortality from congenital heart disease in infants under 1 year has decreased significantly since 1990, though it remains a major cause of infant death, highlighting the need for improved screening and treatment.
Declining global infant CHD mortality supports expanded access to care; leaves open regional disparities and causal drivers for targeted interventions.
Background: Previous estimates of congenital heart disease (CHD) have been constrained by limited data sources, narrow geographic focus, and a lack of specific assessment of infants younger than 1 year. As part of the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2021, this research provides comprehensive estimates of mortality, prevalence, and disability attributable to CHD in infants under 1 year. The study encompasses data from 204 countries and territories, covering the period from 1990 to 2021. Methods: This cross-sectional analysis utilized data from the 2021 GBD study, encompassing 204 countries and territories. The study focused on infants under 1 year of age with CHD. The GBD dataset was accessed on June 10, 2024. Main outcome measures: The primary outcomes included prevalence, all-cause, and cause-specific mortality, disability-adjusted life years (DALYs), and the corresponding estimated annual percentage changes (EAPCs). Trends were stratified by region, country, age, and Sociodemographic Index (SDI). Results: In 2021, CHD resulted in 250,811.32 deaths globally [95% uncertainty interval (UI), 207,821.56-304,084.49], representing a 52.58% decrease from 1990. Among these, 167,985.02 deaths (95% UI, 138,221.77-208,321.59) occurred in infants younger than 1 year. In infants under 1 year old, the 1990 mortality rate for CHD ranked behind neonatal encephalopathy due to birth asphyxia and trauma, diarrheal diseases, neonatal preterm birth, and lower respiratory infections. By 2021, its mortality rates had decreased to the eighth leading cause of death. Interpretation: CHD remains a significant and rapidly escalating global challenge in child health. While it is difficult to significantly reduce the prevalence of CHD, especially in complex cases, advances in prenatal diagnosis and the availability of medical termination of pregnancy in certain regions have led to demographic changes. Additionally, birth rates, typically lower in high-SDI countries, also influence the prevalence of CHD. Given these factors, the focus should be on improving survival outcomes and quality of life for affected infants. Our findings reveal substantial global disparities in prevalence among infants under 1 year, emphasizing the need for policy reforms that address screening, treatment, and data collection to mitigate these disparities.
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Deng et al. (2025) conducted a cross-sectional in Congenital heart disease. Time period (2021 vs 1990) vs. 1990 was evaluated on CHD-associated deaths in infants <1 year (-54.58%, 95% CI -65.22 to -23.77). Global congenital heart disease mortality in infants under 1 year decreased by 54.58% from 1990 to 2021, dropping from 369,851 to 167,985 deaths.
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