Infant congenital heart disease prevalence and mortality in French Guiana: a population-based study

Hugues Lucron; Mélanie Brard; Julie d'Orazio; Laurence Long; Véronique Lambert; Serge Zedong-Assountsa; Alix Le Harivel de Gonneville; Patrick Ahounkeng; Saskia Tuttle; Marianna Stamatelatou; Rory Grierson; Jocelyn Inamo; Fabio Cuttone; Narcisse Elenga; Damien Bonnet; Rishika Banydeen

doi:10.1016/j.lana.2023.100649

Infant congenital heart disease prevalence and mortality in French Guiana: a population-based study

Lancet Reg Health Am. 2023 Dec 14:29:100649. doi: 10.1016/j.lana.2023.100649. eCollection 2024 Jan.

Authors

Hugues Lucron¹, Mélanie Brard¹, Julie d'Orazio^{1

2}, Laurence Long², Véronique Lambert³, Serge Zedong-Assountsa⁴, Alix Le Harivel de Gonneville¹, Patrick Ahounkeng⁵, Saskia Tuttle¹, Marianna Stamatelatou¹, Rory Grierson⁴, Jocelyn Inamo^{1

6}, Fabio Cuttone¹, Narcisse Elenga², Damien Bonnet⁷, Rishika Banydeen^{6

8}

Affiliations

¹ Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France.
² Neonatal and Pediatric Department, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France.
³ Fetal Unit. Department of Obstetrics, Hospital Center Franck Joly, Saint-Laurent du Maroni, French Guiana, France.
⁴ Neonatal and Pediatric Department, Hospital Center Franck Joly, Saint-Laurent du Maroni, French Guiana, France.
⁵ Fetal Unit. Department of Obstetrics, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France.
⁶ Cardiac Pathology, Environmental Toxicity and Envenomations (PC2E) Team, UR5_3, Université des Antilles (University of the French West Indies), 97200, Fort de France, France.
⁷ M3C-Necker, Pediatric Cardiology Department, Necker Sick Children Hospital, AP-HP, Paris Cité University, Paris, France.
⁸ Clinical Research Unit, Critical Care and Emergency Medicine Department, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France.

Abstract

Background: Few studies have assessed the prevalence and mortality of simple or complex congenital heart diseases (CHD) in newborns. In Latin America and Caribbean (LAC), CHD epidemiology seems highly variable, with few population-based assessments and different methodologies between studies. To date, the situation in French Guiana, a French overseas territory located in South America between Brazil and Suriname, has never been described.

Methods: We analysed CHD prevalence, characteristics and related infant mortality in French Guiana, with a population-based registry analysis of all fetal and live birth CHD cases in infants under 1 year (January 2012-December 2016).

Findings: Overall, 33,796 births (32,975 live births) were registered, with 231 CHD (56 fetuses), including 215 live births. Most frequent CHD categories were anomalies of the ventricular outflow tract and extra-pericardial trunks, and ventricular septal defects. 18.6% (43/231) chromosomal or genetic anomalies, and 6.5% (15/231) terminations of pregnancy were observed. Total CHD prevalence was 68.4 [95% CI: 67.9-68.8] per 10,000, while live birth prevalence was 65.2 [95% CI: 64.7-65.7] per 10,000. Total infant mortality was 9.4/10,000 live births [95% CI 9.1-9.7], with highest rates for functionally univentricular hearts (FUH).

Interpretation: A distinct profile for CHD is highlighted in French Guiana with elevated mortality linked to FUH. A potential determinant of the recognized excess mortality risk might be the presence of chromosomal or genetic anomalies in about a fifth of all CHD. This helps us to better understand CHD burden in this part of South America and provides future keys towards reducing CHD-related infant mortality.

Funding: The authors received no financial support for the present research, authorship, and/or publication of this article.

Keywords: Chromosomal and genetic anomalies; Congenital heart disease; Infant mortality; Latin America and Caribbean; Prevalence; Univentricular hearts/single ventricle defects.