Epidemiología y registro de las cardiopatías congénitas en Costa Rica

Abstract

Objetivo. Caracterizar la población de niños que nacen con cardiopatías congénitas (CC) en Costa Rica y evaluar sus procesos de registro.

Métodos. Estudio observacional exploratorio que incluyó a todos los niños con CC diag- nosticadas en el Hospital Nacional de Niños entre el 1 de mayo de 2006 y el 1 de mayo de 2007.

Tomando en cuenta los niños menores de 1 año y su respectiva cohorte de nacimientos, se es- timaron prevalencias con intervalos de confianza de 95% (IC95%) según sexo, tipo de cardio- patía, edad al diagnóstico, edad materna, residencia habitual y malformaciones extracardiacas

asociadas. Se compararon los datos con el Centro de Registro de Enfermedades Congénitas (CREC). Resultados. Durante el período estudiado se diagnosticaron 534 casos con CC. Los casos en menores de 1 año fueron 473 dentro de una cohorte de nacimientos de 77 140 —prevalencia de

0,6% (IC95%: 0,5–0,7). Con base en datos del CREC, se demostró que al nacimiento no se de- tectan 71% de los casos. La edad promedio al diagnóstico en niños menores de 1 año fue de 46,6

días. No hubo diferencias por sexo. La prevalencia de CC en hijos de madres de 35 años o más fue

significativamente mayor, aunque al excluir las cromosomopatías este riesgo perdió su signifi- cancia estadística. Las provincias del país con puertos marítimos fueron las de mayor riesgo en

hijos de madres adolescentes. Las CC más frecuentes fueron los defectos del tabique interventri- cular e interauricular, persistencia del conducto arterioso, estenosis valvular pulmonar, defectos

del tabique aurículo ventricular, coartación de aorta y tetralogía de Fallot. El 34% de las CC fue- ron múltiples, 11,2% se asociaron a cromosomopatías y 19% tenían malformaciones congénitas

asociadas. Conclusiones. La prevalencia de CC en Costa Rica está dentro del rango informado a nivel

mundial. Se halló que en el CREC había un importante subregistro de CC debido principal- mente a los criterios de edad aplicados. Los resultados sugieren que la edad materna (menores

de 20 años y mayores de 34 años) es un factor asociado a la ocurrencia de CC.Objective. To characterize the population of children born with congenital heart disease (CHD) in Costa Rica and to evaluate the Costa Rica and to evaluate their registration processes.

Methods. Exploratory observational study that included all children with congenital heart disease (CHD) diagnosed at the National Children's Hospital between May 1, 2002 and May 1, 2003. The study included all children with congenital heart disease diagnosed at the National Children's Hospital between May 1, 2006 and May 1, 2007.

Taking into account children under 1 year of age and their respective birth cohorts, prevalences were estimated with intervals of 1.5 and 2.5. prevalences were estimated with 95% confidence intervals (95%CI) according to sex, type of cardiopathy, age at diagnosis, age at diagnosis, and age at birth. age at diagnosis, maternal age, habitual residence and associated extracardiac malformations.

malformations. Data were compared with the Congenital Disease Registry Center (CREC). (CREC). Results. During the period studied, 534 cases with CC were diagnosed. Cases in under 1 year of age were 473 within a birth cohort of 77 140 -prevalence of 0.6% (ic95%: 0.6%).

0.6% (IC95%: 0.5-0.7). Based on CREC data, it was shown that 71% of cases are not detected at birth. 71% of cases are not detected at birth. The mean age at diagnosis in children under 1 year of age was 46.6 days.

days. There were no differences by sex. The prevalence of CHD in children of mothers aged 35 years or older was significantly higher, although when excluding mothers aged 35 years or older, the prevalence of CHD was significantly higher.

The prevalence of CHD in children born to mothers aged 35 years or older was significantly higher, although when chromosomopathies were excluded, this risk lost its statistical significance. statistical significance. The provinces of the country with seaports were those with the highest risk in children of adolescent mothers.

children of adolescent mothers. The most frequent CC were septal defects of the interventricular and interatrial septum, atrial septal defect, atrial septal defect atrial septal defects, patent ductus arteriosus, pulmonary valvular stenosis, atrioventricular septal defects, atrioventricular septal defects, and atrial septal defects.

atrioventricular septal defects, coarctation of the aorta, and tetralogy of Fallot. Thirty-four percent of the CC were multiple. 11.2% were associated with chromosomopathies and 19% had congenital malformations.

malformations. Conclusions. The prevalence of CHD in Costa Rica is within the range reported worldwide.

worldwide. It was found that in the CREC there was a significant underreporting of CC mainly due to the age criteria applied. The results suggest that maternal age (maternal age) is the most important factor in the prevalence of CHD. The results suggest that maternal age (under 20 years and over 34 years of age)

20 years and older than 34 years) is a factor associated with the occurrence of CHD.