BackgroundCongenital heart defect (CHD) is the most common major malformations in infants. Little is known about the main epidemiologic characteristics of CHD prevalence in Guangdong province, China. Our study was undertaken to investigate the time trends in the prevalence of CHD in Guangdong province from 2008 to 2012.MethodsData were retrieved from the Guangdong Hospital-Based Birth Defects Monitoring System during 2008–2012. All infants more than 28 weeks of gestation and infants up to 7 days of age in monitoring hospitals were monitored. We used prevalence rate to describe the difference in prevalence of CHD between rural and urban areas. Odds ratio (OR) and 95% confidence interval (CI) for CHD were calculated for the rural and urban areas. The CHD rate was calculated on the basis of birth defects per 10,000 births.ResultsA total of 1005052 births were reported to the Birth Defects Monitoring Network of Guangdong Province, of which 5268 cases were diagnosed as CHD. The overall prevalence of CHD was 52.41 per 10 000 births (95% CI: 51.00 ~ 53.83) in provincial-wide, 66.08 per 10 000 births (95% CI: 63.77 ~ 68.39) in urban areas, and 40.23 per 10 000 births (95% CI: 38.52 ~ 41.93) in rural areas. The prevalence of CHD increased with maternal age both in urban areas (P < 0.01) and in rural areas (P < 0.01).ConclusionThe increasing trends of CHD prevalence suggest that maternal age and the improvement of diagnosis ability might play a critical role.

Context Higher blood glucose level during gestational periods has been consistently associated with increased risk of adverse birth outcomes. Evidence regarding the association between higher glycated hemoglobin A1c (HbA1c) within the normal range and adverse birth outcomes is limited. Objective We aimed to examine the association between HbA1c within the normal range and the risk of adverse birth outcomes. Design and Setting The data were abstracted from the Information System of Guangdong Women and Children Hospital, China, from September 2014 to March 2018. Patients A total of 5658 pregnant women with normal gestational HbA1c were included in this analysis. Main Outcome Measures The adverse birth outcomes include preterm birth, macrosomia, and large for gestational age (LGA). Results Among 5658 subjects, the rates of preterm birth, macrosomia, and LGA were 4.6% (261/5658), 3.5% (200/5658), and 5.7% (325/5658), respectively. The results of multivariate logistic regression model showed that each 1% increase in maternal HbA1c was positively associated with increased risks of preterm birth (OR 1.58; 95% CI, 1.08-2.31), macrosomia (OR 1.70; 95% CI, 1.10-2.64), and LGA (OR 1.38; 95% CI, 0.98-1.96). The association between gestational HbA1c and preterm birth was more evident among women with prepregnancy body mass index (BMI) ≤ 24 kg/m2. Conclusions Gestational higher HbA1c level within the normal range is an independent risk factor for preterm birth, macrosomia, and LGA. Intervention for reducing HbAc1 may help to prevent adverse birth outcomes.

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