Study highlights success of 50 years of modern medical interventions for babies with heart defects

A study published in this month’s Archives of Diseases in Childhood shows a marked increase in survival rates for babies born with congenital heart defects (CHDs) during the last 50 years. CHDs are one of the most prevalent birth defects, affecting 68 in 1,000 live births in the UK each year.

The British Heart Foundation-funded study was carried out by researchers at the MRC Centre for Epidemiology of Child Health based at the UCL Institute of Child Health, in collaboration with Great Ormond Street Hospital (GOSH) and The Freeman Hospital in Newcastle-Upon-Tyne. Their investigation shows that technological advancements in this area of paediatric medicine, such as surgery and intensive care, are delivering better outcomes for these children.

The authors considered population data from 1959 to 2009, investigating age, period and birth cohort trends in childhood mortality attributable to CHDs. Their results showed a dramatic decline in death rates, falling from 1,460 in 1959, to just 154 in 2009 for children 15 years and under. Infants under a year comprised over 60 per cent of deaths caused by CHDs between 1959 and 1963, but this fell to 22 per cent in 2004-2008. They also observed that death rates have fallen for both sexes in all age groups, but although the gap appears to be closing, males continue to have slightly higher death rates.

Lead author on the study, Dr Rachel Knowles, Clinical Research Fellow, comments: “This data is very useful as it illustrates the enormous benefit that current approaches to these conditions are bringing to these very ill children. Fifty years ago, the prognosis for a child born with a serious CHD was very bleak. Twenty years ago, it had little improved. Now, the story is entirely different. Clinicians at centres of excellence such as GOSH and The Freeman can offer a variety of complex surgical procedures to babies within their first month of life and with coinciding improvements in anaesthetic and intensive care, the overall picture is now much brighter.”

The study is the first of its kind that looks specifically at age and birth cohorts and their relation to CHD mortality rates over such a long period of technological change. It will be useful in informing the future management of babies born with heart defects in the UK and across other global centres.

Examples of advances and medical innovations can be found in GOSH's Heart and Lung Breakthrough Guide.