ArticleTranslational pediatrics2026
Global and Chinese co-occurrence patterns association with socio-demographic index for congenital heart disease and Down syndrome, 1990-2021.
Article in Translational pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Congenital heart disease (CHD) and Down syndrome (DS) are two major birth defects that severely impact the quality of life and survival of affected children. This study aimed to systematically assess the disease burden, spatial co-occurrence patterns, and associations with the Socio-demographic Index (SDI) for CHD and DS globally and in China from 1990 to 2021. Methods: Data on disability-adjusted life years (DALYs) and prevalence for CHD and DS were extracted from the Global Burden of Disease Study 2021 (GBD 2021) for 204 countries and territories. Temporal trends were evaluated using Joinpoint regression analysis. Disease burden levels were categorized into quartiles to generate co-occurrence maps and year-SDI heatmaps. Results: From 1990 to 2021, global age-standardized DALY rates for CHD and DS exhibited an overall downward trend [estimated annual percentage change (EAPC) =-1.59% and -0.14%, respectively]. China experienced substantially larger declines [CHD, average annual percentage change (AAPC) =-5.03%; DS, AAPC =-3.62%], yet prevalent cases continued to increase, reaching 2.35 million and 1.61 million in 2021, respectively. Globally, the concordant co-occurrence pattern for prevalence predominated (41.66% of countries) and remained persistently stratified by SDI: CHD-dominant in low-SDI regions, DS-dominant in high-SDI regions, and concordant across other SDI strata. In China, the co-occurrence pattern for DALYs shifted from high-high concordant in 1990 to low-low concordant in 2021, while the prevalence pattern transitioned from DS-dominant to concordant in 2017. Conclusions: Over the past 32 years, both global and China levels have seen declines in the DALY burden of CHD and DS, with China achieving a more pronounced reduction. However, the rising prevalence burden highlights that life-course health management remains a weak link. The concordant co-occurrence pattern in prevalence burden suggests that prevention and control strategies for CHD and DS should adopt an integrated approach, addressing both common patterns and unique characteristics of each condition to further improve overall health outcomes.
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