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Deaths from congenital heart disease are declining

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According to the Australian Institute of Health and Welfare (AIHW) report, Congenital heart disease in Australia, heart defects present at birth affect around 2600 Australian babies per year.
 
But mortality rates have declined significantly over the past 30 years, from 1.7 deaths per 100,000 in 1987 to 0.6 in 2017, by which time the overall number of deaths from congenital heart disease totalled just 152, or 0.1% of all deaths.
 
While it remains the leading cause of hospitalisation and death for infants, resulting in 70 fetal deaths and 119 neonatal deaths in 2017, mortality rates have also fallen in children under five since 1987, from 15.1 deaths per 100,000 to 4.8 in 2017.
 
While the majority of deaths from congenital heart disease still occur in children, these rates have also fallen, from 71% in 1987 to 50% between 2007 and 2017. Some have attributed this fall to improvements in treatment and antenatal diagnosis, resulting in a rise in pregnancy terminations following detection of the condition.
 
Whatever the underlying reasons, the figures show that people with congenital heart disease are living longer, reflected by an increase in their mean age of death from 23 years in 1997, to 28 years in 2007 and 30 years in 2017. It was estimated that there were 26,000–32,000 adults living with congenital heart disease in the Australian population in 2011, with an annual increase of 5%.
 
Longer lifespans for people with congenital heart disease means the burden of the disease shifts to adulthood. This requires specialist treatment, as well as management of day-to-day health and welfare issues such as family planning, diet and lifestyle choices, and managing physical limitations.
 
Unlike other forms of cardiovascular disease, hospitalisation rates for congenital heart disease decline as patients grow older.
 
Men and women had similar rates of congenital heart disease, with no statistical difference in death rates between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, or between levels of remoteness. However, socioeconomic position did appear to have an effect, with the death rate higher in the lowest socioeconomic group when compared in the highest.
 
While one third of cases of congenital heart disease can be attributed to chromosomal anomalies and gene disorders, there are known risk factors for congenital heart disease, which include:

• family history
• maternal illnesses, such as rubella
• misuse of alcohol, illicit drugs and over-the-counter or prescription medicines
• maternal health factors, such as early-onset pre-eclampsia and poorly controlled diabetes.

The AIHW report also notes that differences in data collection and statistical methods across states and territories cause some difficulties in providing a comprehensive perspective on the impact of congenital heart disease across Australia.
 
Advocates for people with congenital heart disease are working towards the development of a national registry for the condition to improve data collection and better guide future care and services for this section of the population.

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AIHW cardiovascular congenital heart disease

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