ArticleTranslational pediatrics2026
Trends and projections in the burden of congenital heart disease among children under 5 years, 1990-2035.
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) is a leading cause of preventable deaths from congenital anomalies in children under 5 years. Comprehensive assessments of its burden and future trends in this age group are needed to inform targeted interventions. Using the full time series available in Global Burden of Disease (GBD) Study 2021 (1990-2021), which permits three-decade trend evaluation and provides the latest complete observation window for projection, this study aimed to assess the global, regional, and national burden of CHD in children under 5 years and project trends to 2035. Methods: Using data from GBD 2021, the latest complete annual dataset available at the time of analysis, we analyzed deaths and disability-adjusted life years (DALYs) across 204 countries and territories, stratified by age, sex, and Socio-demographic Index (SDI). Trends were quantified using estimated annual percentage change (EAPC), and future projections were generated using Bayesian age-period-cohort modeling. Results: Globally, CHD deaths decreased by 56.2% from 466,157 in 1990 to 204,223 in 2021, and DALYs declined by 55.7% from 42.0 million to 18.6 million. Mortality and DALY rates fell annually by 2.6% and 2.5%, respectively. Substantial disparities persisted, with low-SDI regions bearing the highest burden while high-middle SDI regions showed the largest declines (EAPC =-5.3% for mortality). In 2021, India recorded the highest number of deaths, China the highest number of DALYs, and Afghanistan the highest mortality and DALY rates. The neonatal period accounted for the largest share of the burden and showed the greatest reduction. Projections indicate continued declines to approximately 100,943 deaths and 9.28 million DALYs globally by 2035. Conclusions: While global progress in reducing the CHD burden has been substantial, major inequities linked to socioeconomic development persist. Targeted policies to strengthen screening, referral, pediatric cardiac surgery and intervention, perioperative intensive care, and equitable financing are needed to improve outcomes worldwide.
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