Survival rates and life expectancies for patients with congenital heart disease (CHD) have dramatically increased, and these patients are now reaching reproductive age. As they reproduce, questions pertaining to recurrent risk of disease and the impact on incidence rates have emerged. Recurrence rates for CHD have been estimated at 3% to 5%, although, due to the complex genetics underlying CHD, this range may represent an underestimation of the true risk. Debate still exists on whether the impact of recurrence of disease has been reflected in incidence rates. Although incidence rates have undoubtedly increased, the mechanism underlying this remains unclear; improved detection likely accounts for the majority of the observed increase; however, a true increase may be present simultaneously. Concurrently, certain factors, including improved fetal detection and elective terminations, infertility, increased rates of spontaneous abortion and intrauterine fetal demise in women with CHD, and folic acid supplementation, are leading to decreases in the incidence of CHD. It is likely that the full impact of improved survival and heritability of CHD on incidence rates remains to be seen and will likely be attenuated by other factors acting to decrease incidence.

中文翻译：

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先天性心脏病生存改善对疾病发生率的影响。

先天性心脏病（CHD）患者的存活率和预期寿命已大大增加，这些患者现已达到育龄。在它们繁殖时，出现了与疾病复发风险及其对发病率的影响有关的问题。冠心病的复发率估计为3％至5％，尽管由于冠心病背后的复杂遗传学，该范围可能代表了对真实风险的低估。关于发病率是否已反映出疾病复发的影响，仍存在争论。尽管发病率无疑增加了，但其背后的机制仍不清楚。改进的检测可能占观察到的增加的大部分；但是，可能同时存在真正的增加。同时，某些因素 包括改善胎儿检测和选择性终止，不育，CHD妇女的自然流产率和宫内胎儿死亡率的增加以及叶酸的补充，均导致CHD发生率降低。冠心病的生存率和遗传力改善对发病率的全面影响仍有待观察，并且可能会因其他降低发病率的因素而减弱。