European Journal of Cardiovascular Medicine

Objective: Congenital heart disease (CHD) is the most common congenital anomaly in newborns and is a significant cause of mortality. The distribution pattern varies with different regions.   The aim of this study was to evaluate the pattern of CHD among referred pediatric population in south India. Methods: This was a single centre cross-sectional observational study done over a period of one year. A total of 616 infants and children referred with suspected CHD to a tertiary care centre in Kerala, from January to December 2019 were included. They underwent routine clinical examination, pulse oximetry and echocardiography. Results: Among the 616 enrolled subjects, 553 had CHD of which 526 (95%) had acyanotic lesions, 20 (3.6%) cyanotic lesions and 7 (1.2%) non-specified CHD.  Among acyanotic CHD, shunt lesions were much common (87%) than obstructive/ regurgitant lesions (13%). Atrial septal defect (ASD) accounted for 54.9% followed by Ventricular septal defect (14.5%) and patent ductus arteriosus (PDA) (13.9%). Pulmonary stenosis was the most common obstructive lesion (4.5%). Tetralogy of Fallot was the commonest among cyanotic CHD (2.1%). In 47 (8.4%) cases a combination of simple defects was seen, the commonest being ASD with PDA in 17 (3%) cases. Only consanguinity (2.6% vs. 0.3%, p 0.02) prematurity (16% vs. 4.4%, p 0.0001) and low birthweight (2.65 Kg vs. 2.89 Kg, p 0.001) were significantly associated with CHD. Conclusion: Among a referral pediatric population, ACHDs were far more common than CCHDs.  Shunt lesions formed the majority of ACHD. While prematurity, low birth weight and consanguinity were the risk factors associated with CHD, parity, birth order and parental age were not. Inclusion of neonates in the study is one probable reason for the large proportion of shunt lesions like ASD in the study.