title: Mortality in infants with cardiovascular malformations.
abstract: Cardiovascular malformations are an important cause of infant death and the major cause of death due to malformation. Our aims were to analyse and categorise all deaths in infants with cardiovascular malformations, and to analyse trends in mortality over time and influences on mortality. We obtained details of infant deaths and cardiovascular malformations from the population of one health region for 1987-2006. We categorised deaths by cause and by presence of additional chromosomal or genetic abnormalities or non-cardiac malformations. In 676,927 live births the total infant mortality was 4,402 (6.5 per 1,000). A total of 4,437 infants had cardiovascular malformations (6.6 per 1000) of whom 458 (10.3%) died before 1 year of age. Of this number, 151 (33%) deaths had non-cardiac causes, 128 (28%) were cardiac without surgery and 179 (39%) occurred from cardiac causes after surgery. Death was unrelated to the cardiovascular malformation in 57% of infants with an additional chromosomal or genetic abnormality, in 76% of infants with a major non-cardiac malformation and in 16% of infants with an isolated cardiovascular malformation. Terminations of pregnancies affected by cardiovascular malformations increased from 20 per 100,000 registered births in the first 5 years to 78 per 100,000 in the last 5 years. A total of 2,067 infants (47%) underwent surgery and of these 216 (10%) died before 1 year of age.
  
  
  CONCLUSIONS
  A total of 10.4% of infants who died had a cardiovascular malformation and two-thirds of deaths were due to the malformation or its treatment. Mortality declined due to increasing termination of pregnancy and improved survival after operation.
authors: Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK. christopher.wren@nuth.nhs.uk
authors: Christopher
authors: C
authors: Wren
authors: Claire A
authors: CA
authors: Irving
authors: Josephine Amanda
authors: JA
authors: Griffiths
authors: John J
authors: JJ
authors: O'Sullivan
authors: Milind P
authors: MP
authors: Chaudhari
authors: Simon R
authors: SR
authors: Haynes
authors: Jon H
authors: JH
authors: Smith
authors: J R Leslie
authors: JR
authors: Hamilton
authors: Asif
authors: A
authors: Hasan
mesh_terms: D000025:Abortion, Eugenic / Q000706:statistics & numerical data; D018376:Cardiovascular Abnormalities / Q000150:complications / Q000235:genetics / Q000401:mortality* / Q000601:surgery; D013504:Cardiovascular Surgical Procedures / Q000401:mortality; D002423:Cause of Death; D000013:Congenital Abnormalities / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D030342:Genetic Diseases, Inborn / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D011247:Pregnancy