Table 3.
Projected Increase in Congenital Heart Defect Burden in United States by Region, Season, and Heat Definition Based on the Previous Positive Findings (2025–2035 Versus 1995–2005)a
| Region | Exposure | Criteria | CHD: OR (95% CI) | Projected Increase in Cases (%) | Baseline Cases for the Seasonb | Projected Increase in Cases (Total N)c | |
|---|---|---|---|---|---|---|---|
| Increase | 95% CI | ||||||
| South (AR/TX) | Spring EHE95 frequency | Maximum | Total: 1.32 (95% CI, 1.04–1.67) | 11.1 | 5.8–16.6 | 21 263 | 2363 (23 626) |
| Median | 12.3 | 5.9–18.9 | 2607 (23 870) | ||||
| Minimum | 8.2 | 5.4–11.0 | 1739 (23 002) | ||||
| Maximum | Conotruncal: 1.72 (1.10–2.69) | 17.4 | 7.0–28.7 | 1525 | 265 (1790) | ||
| Median | 19.7 | 7.4–33.5 | 301 (1826) | ||||
| Minimum | 11.4 | 6.0–17.0 | 174 (1699) | ||||
| Maximum | VSD: 1.67 (1.07–2.62) | 16.6 | 6.4–28.0 | 8334 | 1387 (9721) | ||
| Median | 18.9 | 6.7–32.6 | 1573 (9907) | ||||
| Minimum | 11.0 | 5.7–16.7 | 918 (9252) | ||||
| Spring EHE95 duration | Maximum | Conotruncal: 1.23 (1.00–1.51) | 18.7 | 4.9–34.1 | 1525 | 285 (1810) | |
| Median | 34.0 | 4.9–70.8 | 519 (2044) | ||||
| Minimum | 13.2 | 4.9–22.1 | 202 (1727) | ||||
| Maximum | VSD: 1.24 (1.01–1.52) | 19.3 | 5.5–34.6 | 8334 | 1605 (9939) | ||
| Median | 35.3 | 6.2–72.1 | 2942 (11 276) | ||||
| Minimum | 13.6 | 5.3–22.4 | 1130 (9464) | ||||
| West (CA) | Summer EHD90 counts | Maximum | RVOTO: 1.17 (1.00–1.37) | 2.7 | 0.5–4.9 | 95 | 3 (98) |
| Median | 3.2 | 1.5–4.9 | 3 (98) | ||||
| Minimum | 31.3 | 4.9–64.4 | 30 (125) | ||||
| Midwest (IA) | Summer EHD95 counts | Maximum | Septal: 1.25 (1.04–1.51) | 129.2 | 20.4–344.2 | 1194 | 1543 (2737) |
| Median | 102.7 | 17.8–254.1 | 1227 (2421) | ||||
| Minimum | 62.4 | 13.3–135.0 | 745 (1939) | ||||
| Summer EHE95 frequency | Maximum | Septal: 1.71 (1.09–2.69) | 65.2 | 12.9–142.4 | 1194 | 779 (1973) | |
| Median | 49.4 | 11.1–101.4 | 590 (1784) | ||||
| Minimum | 36.3 | 9.4–70.0 | 433 (1627) | ||||
| Southeast (NC/GA) | Summer EHE90 duration | Maximum | VSD: 1.14 (1.01–1.29) | 22.7 | 6.2–42.1 | 3071 | 696 (3767) |
| Median | 5.6 | 5.0–6.3 | 173 (3244) | ||||
| Minimum | −2.5 | −9.0–4.3 | −77 (2994) | ||||
| Northeast (NY) | Spring EHD90 counts | Maximum | Septal: 1.18 (1.05–1.34) | 32.5 | 12.4–58.5 | 7532 | 2447 (9979) |
| Median | 29.8 | 11.7–52.9 | 2245 (9777) | ||||
| Minimum | 14.2 | 7.6–22.0 | 1073 (8605) | ||||
| Spring EHE90 duration | Maximum | ASD: 1.50 (1.07–2.11) | 51.9 | 11.6–107.4 | 3801 | 1973 (5774) | |
| Median | 24.9 | 8.0–44.7 | 948 (4749) | ||||
| Minimum | 17.5 | 6.9–29.2 | 663 (4464) | ||||
| Maximum | Septal: 1.20 (1.03–1.39) | 23.9 | 7.8–41.7 | 7532 | 1802 (9334) | ||
| Median | 13.5 | 6.3–20.9 | 1016 (8548) | ||||
| Minimum | 10.4 | 5.8–15.0 | 782 (8314) | ||||
| Maximum | VSD: 1.27 (1.06–1.52) | 30.5 | 10.7–53.8 | 3732 | 1138 (4870) | ||
| Median | 16.3 | 7.6–25.7 | 608 (4340) | ||||
| Minimum | 12.1 | 6.6–17.9 | 453 (4185) | ||||
| Spring EHD95 counts | Maximum | Septal: 1.39 (1.13–1.72) | 37.3 | 16.0–63.5 | 7532 | 2812 (10 344) | |
| Median | 33.9 | 14.9–56.8 | 2555 (10 087) | ||||
| Minimum | 5.4 | 5.1–5.7 | 405 (7937) | ||||
| Spring EHE95 duration | Maximum | ASD: 1.87 (1.11–3.16) | 42.5 | 10.4–84.1 | 3801 | 1614 (5415) | |
| Median | 38.6 | 9.9–75.1 | 1468 (5269) | ||||
| Minimum | 1.8 | −0.7–4.4 | 70 (3871) | ||||
| Maximum | Septal: 1.30 (1.05–1.62) | 19.3 | 7.5–32.8 | 7532 | 1452 (8984) | ||
| Median | 17.9 | 7.2–30.1 | 1350 (8882) | ||||
| Minimum | 3.6 | 4.7–2.5 | 272 (7804) | ||||
| Maximum | VSD: 1.44 (1.11–1.88) | 25.4 | 10.4–42.8 | 3732 | 948 (4680) | ||
| Median | 23.4 | 9.9–39.0 | 874 (4606) | ||||
| Minimum | 3.1 | 1.8–4.4 | 116 (3848) | ||||
| Southwest (UT) | Spring EHE95 duration | Maximum | Conotruncal: 1.34 (1.00–1.81) | 3.2 | 1.4–4.9 | 180 | 6 (186) |
| Median | 12.7 | 4.9–21.3 | 23 (203) | ||||
| Minimum | 31.2 | 4.9–65.1 | 56 (236) | ||||
| Summer EHE95 frequency | Maximum | LVOTO: 1.53 (1–2.35) | 6.2 | 4.9–7.5 | 293 | 18 (311) | |
| Median | 22.4 | 4.9–42.9 | 66 (359) | ||||
| Minimum | 19.9 | 4.9–37.3 | 58 (351) | ||||
ASD indicates atrial septal defect; CHD, congenital heart defect; EHD, excessively hot day; EHE, extreme heat event; LVOTO, left ventricular outflow tract obstruction; OR, odds ratio; RVOTO, right ventricular outflow tract obstruction; VSD, ventricular septal defect.
a
Projections were made where significant OR was observed at baseline.
b
Average annual number of cases for this season over 1995–2005.
c
Projected increase of cases for this season over 2025–2035, accounting for 4.9% birth increase.