National Trends and Disparities in Congenital Heart Disease Mortality in the United States, 1999-2024.

PMID 41528440 | DOI 10.1007/s00246-025-04156-1 · Pediatric cardiology · 2026

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INTRODUCTION: Congenital heart disease (CHD) is the most prevalent birth defect, affecting nearly 1% of live births in the United States. Despite advances in diagnosis and treatment, CHD remains a major contributor to morbidity and mortality, with persistent demographic and regional disparities. This study examined national mortality trends and sociodemographic patterns in CHD-related deaths across the U.S. from 1999 to 2024. METHODS: Mortality data were extracted from the CDC WONDER Multiple Cause of Death database using ICD-10 codes Q20–Q26. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 individuals using the 2000 U.S. standard population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APC) and identify significant inflection points. RESULTS: A total of 120,626 CHD-related deaths were reported between 1999 and 2024. Infants accounted for the highest mortality (crude rate 54.2), with most deaths occurring in medical facilities (77%). National AAMR averaged 1.6 (95% CI: 1.3–2.0), declining significantly from 1999 to 2014 (APC − 2.6%) before increasing from 2014 to 2024 (APC + 1.2%). Mortality was higher among males, non-Hispanic Black, and American Indian/Alaska Native populations. Geographic disparities persisted, with higher rates in the Midwest and rural regions. CONCLUSION: After years of improvement, CHD mortality in the U.S. has risen since 2014, highlighting persistent inequities tied to race, geography, and healthcare access. Targeted public health strategies are needed to strengthen adult CHD care networks, reduce structural disparities, and improve long-term outcomes.