[A] European Prevalence 1981–2012 (95% CI) with trend for 2003–2012 (black line) and trend excluding outliers (red line) [B] Prevalence for 2003–2012: European (99% CI vertical grey line) and registry (95% CI) [C] Annual change in prevalence for 2003–2012: European (black line and 99% CI funnel) and registry (linear trend black dots, non-linear trend open diamonds). Red line is no trend. Severe CHD includes single ventricle, hypoplastic left heart, hypoplastic right heart, Ebstein anomaly, tricuspid atresia, pulmonary valve atresia, common arterial truncus, atrioventricular septal defects, aortic valve atresia/stenosis, transposition of great vessels, tetralogy of Fallot, total anomalous pulmonary venous return, and coarctation of aorta.