Prevalence, Clinical Profile, and Factors Associated With Congenital Heart Disease in Children Diagnosed at National Referral Hospital, Bhutan: A Cross‐Sectional Study

Background Congenital heart disease is a structural or functional abnormality of the heart. The prevalence of congenital heart disease varies between countries, and mortality and morbidities are high in children with congenital heart diseases. This study evaluated the prevalence, clinical profile, and the factors associated with congenital heart diseases in children in Bhutan. Methods A cross‐sectional study was conducted at the Department of Pediatrics at the Jigme Dorji Wangchuck National Referral Hospital from January 1 to December 31, 2021. All pediatric patients aged 0 days to 12 years diagnosed with congenital heart disease (CHD) by echocardiography during the study period were included. Data were analyzed using IBM SPSS Statistics version 23. Results In 2021, a total of 41,145 pediatric patients attended the Department of Pediatrics at the Jigme Dorji Wangchuck (JDW) National Referral Hospital, among whom 221 were diagnosed with congenital heart disease (CHD), corresponding to a hospital prevalence of 0.54% (5.4 per 1000 pediatric patients). CHD was observed slightly more frequently in female than male children (50.2% vs. 49.8%, p > 0.05). More than two‐thirds of CHD cases (68.3%) were diagnosed during the neonatal period, while over one‐quarter were diagnosed between 1 month and 1 year of age. The median age at diagnosis was 30 days (IQR: 7–60 days). The most common presenting symptoms were breathlessness (26.7%), poor weight gain (26.2%), and cough (21.7%), and 78.3% of the children had audible heart murmurs on examination. The most frequently identified CHD was atrial septal defect (ASD) (74.2%), followed by ventricular septal defect (VSD) (29.9%) and patent ductus arteriosus (PDA) (20.4%). On multivariable logistic regression, female children showed a lower likelihood of having VSD compared with male children (aOR 0.5, 95% CI 0.28–0.95, p = 0.036), though this did not reach the Bonferroni‐corrected significance threshold ( p < 0.017). Female children were 1.5 times more likely to have ASD than male children, though this was not statistically significant (aOR 1.5, 95% CI 0.77–2.74, p = 0.245). Conclusion The prevalence of congenital heart disease was 5.4 per 1000 pediatric patients, with most cases diagnosed postnatally, predominantly during the neonatal period. Atrial septal defect, ventricular septal defect, and patent ductus arteriosus were the most common types. These findings highlight the need to implement prenatal fetal cardiac screening to enable early detection and timely intervention, thereby improving outcomes for affected newborns.