Objective  Analysis of the disease burden and trends of congenital heart disease (CHD) among children under 14 years of age in China from 1990 to 2021.

Methods  Based on the Global Burden of Disease Study 2021 (GBD 2021) database, incidence, mortality, disability-adjusted life year (DALY), and average annual percent change (AAPC) were employed as indicators to assess the burden of CHD among children under 14 years of age in China and globally from 1990 to 2021. The burden of CHD across various age groups and genders within China were also delineated.

Results  In 2021, the incidence rate of CHD in China was 1,615.39/100,000, the mortality rate was 5.39/100,000, and the DALY rate was 504.05/100,000 person years. Compared to 1990, these rates have decreased by 16.10%, 85.04%, and 84.34%, respectively, with a significantly faster decline trend than the global average during the same period. The AAPC for the incidence, mortality, and DALY rates of CHD in China from 1990 to 2021 were -0.57[95%CI(- 0.62, -0.51)], -6.01[95%CI(-6.35, -5.67)], and -5.84[95%CI(-6.19, -5.50)], respectively. The incidence rate of CHD in male children was higher than in female children, and the mortality rate and DALY were higher than in females except in the 2~4 years age group. The mortality and DALY rates were highest in children aged 0~28 days group and gradually decreased with age, being lowest in children aged 10~14 years group. In different sociodemographic index (SDI) regions, the incidence rate, mortality and DALY rate of CHD in children aged 0~14 years in China have decreased more than those in SDI regions from 1990 to 2021.

Conclusion The incidence, mortality, and DALY rates for CHD in China have all shown a downward trend, with the rate of mortality decline being particularly rapid and exceeding the global average. However, there remains a gap between the incidence and mortality rates in China and those in regions with high SDI. This suggests that China still needs to enhance and improve the treatment methods for CHD to improve the prognosis of CHD children.

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