A Post Hoc Analysis on the Incidence of Congenital Heart Disease in Baku-Azerbaijan calculated by a Prospective Epidemiology Study

Published: Mar 10, 2023
Incidence of Congenital Heart Disease Azerbaidjan - Congenital Heart Disease
Andreas Petropoulos

Background: The incidence of Congenital Heart Disease (CHD)in Azerbaijan was firstly published following  a prospective study, using Echo-2D as a study method, in 2019.

Aim:  Of this post hoc analysis of the first ever prospective epidemiology study that calculated incidence and types of CHD in Baku, Azerbaijan, is to verify the forms of diseases that will have and early clinical impact on the patients and the health system of the country.

Population-method: From June 2016 to August 2018, 2570, term neonates were screened in 2 major state maternity hospitals in Baku. Their screening was randomized to equal females/males with not known previous obstetric alert regarding CHD. Scanning was done by two teams of pediatric cardiologists by using echo-2D. Each team was ‘blinded’ to the findings of each other. All scans were recorded, and a third senior physician reevaluated them.

Results: From 2570 term neonates of the general population, they detected 47 CHD’s. From them, 17 were critical and severe-CHD and 7/47(14.9%) were  of moderate complex. 17/47 (36.2%) were cyanotic and 30/47(63.8%) were non-cyanotic. The incidence of simple CHD was 25/47(53.2%). Analysis of the specific anatomy is presented in table1. The estimated incidence was 1.83%.  As this incidence has been among the highest reported a post hoc analysis has clarified and presented an important clinical rate of 1.48% after redacting minimal defects without any clinical significance, as minor PDA’s, ASD II, VSD’s. A post hoc calculation of BAov, revealed an anatomical BAov incidence of 1.65% and a functional BAov incidence of 1.4%.

Conclusions: This first-ever prospective epidemiology study in Azerbaijan involving a cohort equal to 1.65% of the annual living births of the country, estimated a high incidence of CHD. This is among the highest reported globally.  The amount of critical and severe CHD after the post hoc analysis increased from 46.8% to 55.3%. The incidence of cyanotic CHD after the post hoc analysis increased from 36.2% to 42.1%.  These high numbers are possibly related to an isolated population and conjugated marriage customs of the country. As this represented a state population health burden a post hoc analysis based on clinical important CHD minimized the calculated index nearby 20%.

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Author Biography
Andreas Petropoulos, 1.Dep. of Pediatric Congenital Heart Surgery and CICU, IASO-Pediatric Hospital, Athens -Greece

1.Dep. of Pediatric Congenital Heart Surgery and CICU, IASO-Pediatric Hospital, Athens -Greece,

2. Dep of Pediatric Cardiology Merkezi Klinika, Baku, Azerbaijan;

3. The ‘Aziz Aliyev’ national postgraduate and CME medical training center, Baku, Azerbaijan

Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history; (1971); Circulation; 43:323–332.
Hoffman J I E, Kaplan S; The Incidence of Congenital Heart Disease; (2002); JACC Vol. 39, No. 12
Zimmerman MS, Carswell Smith AG, Sable GA, et.al for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 ; Global, regional, and national burden of congenital heart disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017; (2020); Lancet Child Adolesc Health; 4: 185–200
Hoffman J I E; The global burden of congenital heart disease;(2013); Cardiovascular Journ. of Africa ; Vol 24, No 4
Petropoulos AC, Hudiyeva A, Behbudov V, Mustafayeva G, Guliyev N, Huseynov R, Seyidov N; The incidence of congenital heart disease in Baku-Azerbaijan. prospective epidemiology study; (2019); ADC 2019;104(Suppl 3): A1–A428
Petropoulos AC; The Bicuspid Aortic Valve Syndrome: A Multifaceted Challenge: Do We Know Enough; J Cardiol 2018, 2(4): 00012 9
Wren C. The epidemiology of cardiovascular malformations. In: Moller JH, Hoffman JIE, Benson DW, van Hare GF, Wren C, eds. Pediatric Cardiovascular Medicine; (2012); Oxford, England: Wiley-Blackwell :268–275
Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution;(2007); Circulation;115:163–72
Bernier PL, Stefanescu A, Samoukovic G, et al. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts; (2010); Sem thorac cardiovasc surg. Pediatr Card Surg A ; 13:26–34.
Du ZD, Roguin N, Wu XJ. Spontaneous closure of muscular ventricular septal defect identified by echocardiography in neonates;(1998) Cardiol Young ;8:500–5.
Wolfenden J.L, Petropoulos AC, Carvalho JS; Apical and mid-muscular ventricular septal defects in the fetus: prenatal characteristics and outcome; (2007); Ultrasound in Obstetrics & Gynecology; 30: 456–546
Brassard M, Fouron JC, van Doesburg NH, Mercier LA, De Guise P. Outcome of children with atrial septal defect considered too small for surgical closure; (1999); Am J Cardiol ;83:1552–5.
Lloyd TR, Beekman RH, 3rd. Clinically silent patent ductus arteriosus (letter);(1994); Am Heart; 127:1664–5
Petropoulos A C , Daskalakis G, Anatolitou F, Eleftheriadis M , Antsaklis P , Moutafi A, Petropoulos P , Varvarigou A, Charitou A; The importance of screening for critical and severe congenital cardiac diseases by pulse oximetry in the early neonatal age; Position statement of the Hellenic Society of Perinatal Medicine; Journal of Pediatric and Neonatal Individualized Medicine 2021;10(2):e100211
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