Mortality Resulting From Congenital Heart Disease Among Children and Adults in the United States, 1999 to 2006

Suzanne M. Gilboa, PhD; Jason L. Salemi, MPH; Wendy N. Nembhard, PhD;David E. Fixler, MD; Adolfo Correa, MD, PhD From the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Ga (S.M.G., A.C.); Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa (J.L.S., W.N.N.); and Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (D.E.F.). Correspondence to Suzanne M. Gilboa, PhD, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mail Stop E-86, 1600 Clifton Rd, Atlanta, GA 30333. E-mail sgilboa@cdc.gov

Background— Previous reports suggest that mortality resulting from congenital heart disease (CHD) among infants and young children has been decreasing. There is little population-based information on CHD mortality trends and patterns among older children and adults.
Methods and Results— We used data from death certificates filed in the United Statesfrom 1999 to 2006 to calculate annual CHD mortality by age at death, race-ethnicity, and sex. To calculate mortality rates for individuals 1 year of age, population counts from the US Census were used in the denominator; for infant mortality, live birth counts were used. From 1999 to 2006, there were 41 494 CHD-related deaths and 27 960 deaths resulting from CHD (age-standardized mortality rates, 1.78 and 1.20 per 100 000, respectively). During this period, mortality resulting from CHD declined 24.1% overall. Mortality resulting from CHD significantly declined among all race-ethnicities studied. However, disparities persisted; overall and among infants, mortality resulting from CHD was consistently higher among non-Hispanic blacks compared with non-Hispanic whites. Infant mortality accounted for 48.1% of all mortality resulting from CHD; among those who survived the first year of life, 76.1% of deaths occurred during adulthood (18 years of age).
Conclusions— CHD mortality continued to decline among both children and adults; however, differences between race-ethnicities persisted. A large proportion of CHD-related mortality occurred during infancy, although significant CHD mortality occurred during adulthood, indicating the need for adult CHD specialty management.