cases at any given point in time and is important for defining the requirement for resources and the burden of disease within the total population This study applies assumptions regarding prevalence at live birth and survival to estimate this number, with particular reference to adults with congenitally malformed hearts Jenkins KJ, Correa A, Feinstein JA, et al Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics Circulation 2007;115:2995–3014 This is a contemporary review of studies estimating prevalence aimed at summarizing nongenetic risk factors of potential etiologic and preventive relevance Wilson PD, et al Attributable fraction for cardiac malformations Am J Epidemiol 1998;148:414– 423 The Baltimore-Washington Infant Study was based on active surveillance with a case-control design and was aimed at identifying potential genetic and environmental risk factors This report estimates the contribution to the occurrence of specific defects of familial and environmental risk factors Gill HK, et al Patterns of recurrence of congenital heart disease: an analysis of 6,640 consecutive pregnancies evaluated by detailed fetal echocardiography J Am Coll Cardiol 2003;42:923–929 The investigators examined fetal echocardiograms for pregnancies where either the mother, father or a sibling had congenital cardiac disease They noted a recurrence risk in the fetus of 2.7%, with variable concordance for specific lesions or groups Calcagni G, Digilio MC, Sarkozy A, et al Familial recurrence of congenital heart disease: an overview and review of the literature Eur J Pediatr 2007;166:111–116 This is a contemporary review of patterns of familial recurrence and associated factors Germanakis I, Sifakis S The impact of fetal echocardiography on the prevalence of liveborn congenital heart disease Pediatr Cardiol 2006;27:465–472 These investigators used mathematical modeling of the probability of fetal screening, detection of defects, and elective termination to determine the potential impact on the prevalence at live birth Marelli AJ, et al Congenital heart disease in the general population: changing prevalence and age distribution Circulation 2007;115:163–172 These investigators used administrative databases in the context of a system for health care providing universal coverage, to determine the point prevalence of congenital cardiac disease in adults In 2000 the point prevalence was 4.09 per 1000 adults for any type of defect and 0.38 for serious lesions Mitchell SC, Korones SB, Berendes HW Congenital heart disease in 56,109 births Incidence and natural history Circulation 1971;43:323–332 This study is one of the first to use a surveillance program involving major tertiary centers and defined prevalence at birth of 8.14 per 1000 before verification with echocardiography was possible Cases diagnosed at stillbirth were included, and an important proportion of cases diagnosed with clinical evaluation only were included Report of the New England Regional Infant Cardiac Program Pediatrics 1980;65(suppl 2):375–461 Although primarily a program for health care, a ... diagnosed with clinical evaluation only were included Report of the New England Regional Infant Cardiac Program Pediatrics 1980;65(suppl 2):375–461 Although primarily a program for health care, a