Pediatr Res. 2026 Sep 11. doi: 10.1038/s41390-026-05430-5. Online ahead of print.
ABSTRACT
BACKGROUND: Congenital heart defects (CHDs) affect approximately 9 per 1000 live births in India, generating an estimated 180,000 to 200,000 new cases annually. Despite this burden, contemporary national data on CHD related mortality trends remain limited.
METHODS: Using the Global Burden of Disease 2021 dataset, we analyzed trends in CHD related infant (CHD-IM) and neonatal mortality (CHD-NM) in India from 1990 to 2021, benchmarked against global trends, and estimated associated economic losses using human capital and value of statistical life (VSL) frameworks.
RESULTS: Between 1990 and 2021, India accounted for approximately 1.5 million of 8.6 million global CHD related infant deaths, roughly 18% of the global burden. India’s CHD-NM declined at an annual percent change of -1.5%, significantly slower than the global rate of -2.2%. Segmental analysis revealed stagnation during 2003 to 2013, followed by a nearly threefold acceleration in 2019 to 2021. Substantial subnational inequities in mortality reduction were also identified. The estimated economic loss from CHD related infant deaths in India reached USD 11.7 billion in 2021.
CONCLUSIONS: These findings highlight persistent gaps in early detection, equitable cardiac care access, and neonatal infrastructure as critical targets for sustaining and accelerating mortality reduction in India.
IMPACT: Critical congenital heart disease (CHD) continues to be an important contributor to child mortality in India. Persistent gaps in population-level mortality data obscure the true magnitude of the burden, undermining targeted policy responses. Declines in neonatal and infant mortality attributable to CHD have lagged behind global trends. CHD-related infant mortality in India was associated with an estimated $9-12 billion in lost economic value. Comprehensive system-level reforms are needed to expand pediatric cardiology training, improve service delivery in public healthcare facilities, and strengthen national surveillance and longitudinal follow-up.
PMID:42728311 | DOI:10.1038/s41390-026-05430-5
