Temporal Trends of Infant Mortality Secondary to Congenital Heart Disease: National CDC Cohort Analysis (1999-2020)

Background: Infant mortality remains a significant problem for congenital heart disease (CHD) patients. Limited data exist on the recent trends of mortality in infants with CHD. Methods: The CDC WONDER (Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research) was queried to identify deaths occurring within the U.S. with CHD listed as one of the causes of death between 1999-2020. Subsequently, trends were calculated using the Joinpoint regression program. Results: A total of 47,015 deaths occurred in infants due to CHD from the year 1999 - 2020. On trend analysis, proportional mortality for infants declined from 47.3% in 1999 to 37.1% in 2020 with an AAPC of -1.1 (95% CI -1.6 to -0.6, p<0.001). There was a significant decline in proportional mortality in Black and White patients, from 45.3% in 1999 to 34.3% in 2020 and 55.6% in 1999 to 48.6% in 2020, respectively, with a steeper decline among White than Black patients. Additionally, we observed a statistically significant decline in the proportional mortality of infants in both non-Hispanic and Hispanic patients with an AAPC of -1.3% (95% CI -1.9 to -0.7, p<0.001) and -0.7(95% CI -0.9 to -0.4, p<0.001), respectively, with a steeper decline among non-Hispanic infant population. Conclusion: Our study showed a significant decrease in CHD-related mortality rate in infants between 1999-2020. However, female, Black and Hispanic patients showed a lesser decline than male, White, and non-Hispanic patients.