title: Trends in Mortality of Congenital Heart Defects.
abstract: OBJECTIVE
  The aim of the present nationwide cohort study was to describe trends in 1-year mortality in live-born children with congenital heart defects in Norway 1994-2009 and to assess whether changes in the proportion of terminated pregnancies and altered operative mortality have influenced these trends.
  
  
  METHODS
  Medical information concerning all 954 413 live births, stillbirths, and late-term abortions in Norway, 1994-2009, was retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry for Congenital Heart Defects and the Norwegian Cause of Death Registry. Survivors were followed through 2012.
  
  
  RESULTS
  The 1-year cumulative mortality proportion during the study period was 17.4% for children with severe congenital heart defects and 3.0% for children with nonsevere congenital heart defects. The 1-year cumulative mortality proportion among live born children with severe congenital heart defects decreased 3.6% (95% CI: -5.4, -1.5) per year. The total mortality of severe congenital heart defects was unchanged when including stillbirths and late-term abortions with severe congenital heart defects. The proportion of stillbirths or terminated pregnancies with severe congenital heart defects among all pregnancies with severe congenital heart defects, was on average 8.8% over the entire period with an annually increase of 16.6% (11.4, 18.0). The mean operative mortality in children with severe congenital heart defects was 8.4% and decreased by 9.0% (-11.9, -5.9) per year.
  
  
  CONCLUSIONS
  The 1-year mortality of severe congenital heart defects among live births, 1994-2009, declined in Norway. The downward trend in mortality may be explained by a more frequent use of termination of affected pregnancies, and the reduced operative mortality of severe congenital heart defects.
authors.affiliation: Department of Cardiology, Sørlandet Hospital, Arendal, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Jarle
authors.initials: J
authors.lastname: Jortveit
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: Nina
authors.initials: N
authors.lastname: Øyen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Leirgul
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Fomina
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Stein Emil
authors.initials: SE
authors.lastname: Vollset
authors.affiliation: Research Department, Sørlandet Hospital, Kristiansand, Norway.
authors.forename: Leif
authors.initials: L
authors.lastname: Eskedal
authors.affiliation: Women's and Children's Department, Oslo University Hospital, Oslo, Norway.
authors.forename: Gaute
authors.initials: G
authors.lastname: Døhlen
authors.affiliation: Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Sigurd
authors.initials: S
authors.lastname: Birkeland
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Women's and Children's Department, Oslo University Hospital, Oslo, Norway.
authors.forename: Henrik
authors.initials: H
authors.lastname: Holmstrøm
mesh_terms: D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Congenital Heart Defects; Mortality; Termination of Pregnancies