Congenital heart disease-related mortality during the first year of life: The Peruvian experience

Congenital heart disease (CHD) affects 1% of all live births globally, with critical CHD (CCHD) requiring early intervention to avoid neonatal mortality. To date, CHD-related mortality within the first year of life and its associated factors have not been studied in Peru. This is an observational secondary analysis using the Peruvian National Computerized System of Deaths, data from 2017 to 2021. CHD-related mortality was assessed by sex, age, altitude level, region, insurance type, healthcare institution, contributing factors, and CHD complexity. Geographic patterns were visualized using heatmaps, trends were analyzed through linear regression and survival analyses were performed using Kaplan Meier curves and log-rank tests. Peru experienced 70.6 CHD-related deaths per 100,000 live births. Mortality was significantly higher in males, most CHD-related deaths took place at a median age of 1 month. Regions like Huancavelica and Junín, located in the Andes, exhibited the highest mortality rates. Others significant related factors were receiving care at healthcare institution operated by Ministry of Health (MINSA) and complex CHDs. A non-significant increase in CHD-related deaths and mortality rates was noted, particularly affecting regions such as La Libertad and Lima. Peru faces a critical public health crisis concerning CHD-related mortality among infants, especially those living in the Andes and receiving care at healthcare institutions operated by MINSA. A National Congenital Heart Disease Program is essential to ensure equitable access to specialized care, potentially saving numerous young lives. •CHD affects 1% of live births worldwide, emphasizing its global significance as a critical health concern.•Neonatal mortality is linked to critical CHD, highlighting the urgency of early interventions to improve survival rates.•Peru experiences 70.6 CHD-related deaths per 100,000 live births, shedding light on the severity of the issue within the country.•Mortality rates vary significantly among regions, with Huancavelica and Junín, part of the Andes, showing the highest rates. Factors such as male sex, prematurity, type of healthcare institution and complex CHDs contribute to elevated risks.