Results of the Implementation of Methodological Guidelines for Reducing Infant Mortality from Congenital Heart Defects in the Russian Federation

Introduction. Congenital developmental anomalies, including congenital heart defects (CHDs), are the second leading cause of infant mortality in Russia. Key measures to reduce infant mortality due to CHDs include standardizing prenatal and postnatal diagnostics, establishing patient routing pathways to ensure access to specialized health care, and improving the quality of care at all stages. Currently, management challenges remain unresolved regarding the improvement of statistical reporting forms and CHD registries, digitalizing the tracking of cardiac surgery and organizing lifelong follow-up care for patients with CHD.

Aim: To evaluate the effectiveness of implementing methodological recommendations for reducing CHD-related mortality across the constituent entities of the Russian Federation and to propose targets that reflect the improvement of the quality of health care for children with CHD.

Materials and methods. The analysis used data on the number of births in 2024 to estimate the expected number of children with CHD, information on the inclusion of health institutions in the routing scheme (13 federal and 9 regional centers), and indicators of organizational activities for fetal and neonatal CHD diagnosis and patient routing across 39 constituent entities of the Russian Federation.

Results. Over the past 35 years, infant mortality in Russia has decreased by 79.3%. Despite the reduction in the absolute number of cardiac surgeries for CHD between 2020 and 2025, there has been a pronounced and sustained decline in postoperative mortality across all key patient groups, indicating improved quality of surgical care and better perioperative patient management. The most significant progress has been achieved in infants under 1 year of age: the postoperative mortality rate decreased by nearly 2.5-fold. The article proposes target indicators for the quality of health care provided to children with CHD to be used as standards for healthcare management at the regional level.

Conclusion. Implementation of the methodological recommendations aimed at reducing infant mortality has improved the quality of health care provided to newborns with CHD and helped standardize diagnostic and treatment approaches across different constituent entities of the Russian Federation, with an emphasis on early detection of critical CHD. However, the lack of a unified data collection methodology limits the strength of the evidence base and complicates objective assessment of the situation. Introducing a digital registry for cardiac surgical interventions could partially address this issue and enhance the monitoring of care provided to children with CHD.

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