Outcome of preterm infants with congenital heart disease

Dees, Ellen; Lin, Hwei; Cotton, Robert B.; Graham, T.P.; Dodd, Debra A.

doi:10.1067/mpd.2000.108568

Cited by 99 publications

(79 citation statements)

References 17 publications

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“…Studies of preterm infants with congenital heart disease showed a similar pattern of increased mortality, and preterm infants with ventricular septal defects (VSDs) were more likely to require surgical repair of the defect compared with term infants with VSDs [17]. Higher operative mortality rates were also reported for preterm infants undergoing open surgical procedures for congenital heart defects compared with term infants [36]. Bronchopulmonary dysplasia (BPD) occurs almost exclusively in very preterm infants, and infants with BPD who underwent surgery for congenital heart disease had significantly higher rates of postoperative complications and mortality compared with age and lesionmatched controls [37].…”

Section: Discussionmentioning

confidence: 96%

The Association Between Major Birth Defects and Preterm Birth

Honein¹,

Kirby

Meyer

et al. 2008

Matern Child Health J

112

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Objective To evaluate the association between preterm birth and major birth defects by maternal and infant characteristics and specific types of birth defects. Study Design We pooled data for 1995-2000 from 13 states with population-based birth defects surveillance systems, representing about 30% of all U.S. births. Analyses were limited to singleton, live births from 24-44 weeks gestational age. Results Overall, birth defects were more than twice as common among preterm births (24-36 weeks) compared with term births (37-41 weeks gestation) (prevalence ratio [PR] = 2.65, 95% confidence interval [CI] 2.62-2.68), and approximately 8% of preterm births had a birth defect. Birth defects were over five times more likely among very preterm births (24-31 weeks gestation) compared with term births (PR = 5.25, 95% CI 5.15-5.35), with about 16% of very preterm births having a birth defect. Defects most strongly associated with very preterm birth included central nervous system defects (PR = 16.23, 95% CI 15.49-17.00) and cardiovascular defects (PR = 9.29, 95% CI 9.03-9.56). Conclusions Birth defects contribute to the occurrence of preterm birth. Research to identify shared causal pathways and risk factors could suggest appropriate interventions to reduce both preterm birth and birth defects.

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Section: Discussionmentioning

confidence: 96%

The Association Between Major Birth Defects and Preterm Birth

Honein¹,

Kirby

Meyer

et al. 2008

Matern Child Health J

112

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“…There was no denominator of term infants and no population data, but those authors did report an increased prevalence of "conotruncal defects," compared with the BaltimoreWashington Infant Study 24 (which itself had a fairly low overall ascertainment rate). Dees et al 23 found that the in-hospital mortality rate for preterm infants was increased by a factor of 2.6 by the presence of a cardiovascular malformation and the risk of necrotizing enterocolitis was increased by a factor of 1.7. The mortality rate for cardiac surgery was twice as high among preterm infants, compared with term infants.…”

Section: E836mentioning

confidence: 99%

“…Their study had no denominator group of term infants, no ascertainment of diagnoses made after initial discharge from the hospital, and no correction for ascertainment bias related to referral patterns. Dees et al, 23 in a larger study of admissions to a single NICU, found 16 per 1000 infants had cardiovascular malformations. There was no denominator of term infants and no population data, but those authors did report an increased prevalence of "conotruncal defects," compared with the BaltimoreWashington Infant Study 24 (which itself had a fairly low overall ascertainment rate).…”

Section: E836mentioning

confidence: 99%

Cardiovascular Malformations Among Preterm Infants

2005

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ABSTRACT. Objective. Preterm birth and cardiovascular malformations are the 2 most common causes of neonatal and infant death, but there are no published population-based reports on the relationship between them. We undertook this study to determine the prevalence and spectrum of cardiovascular malformations in a preterm population, the prevalence of prematurity among infants with cardiovascular malformations, and the influence of prematurity and cardiovascular malformations on outcomes.Methods. We based the study on the population of the former Northern Health Region of England. We identified all live-born infants with cardiovascular malformations diagnosed in the first 1 year of life from the regional pediatric cardiology database, which includes the gestational age and details of the diagnosis. We limited ascertainment to malformations diagnosed by the age of 12 months. Infants with isolated patent ductus arteriosus or atrial septal defect were excluded, to avoid ascertainment bias. Infants with ventricular septal defect were classified according to whether they required surgery in the first 1 year. There are no population data on gestational ages for all births in our population for the era of this study; therefore, we used data published in the literature for populations similar to our own to predict that 0.4% of live births occur at <28 weeks of gestation, 0.9% at 28 to 31 weeks, and 6% at 32 to 36 weeks. Overall, 7.3% of live-born infants are preterm.Results. Of 521 619 live-born infants in 1987-2001, 2964 had cardiovascular malformations (prevalence: 5.7 cases per 1000 live births). Cardiovascular malformations were present at 5.1 cases per 1000 term infants and 12.5 cases per 1000 preterm infants. The odds ratio (OR) for a cardiovascular malformation in prematurity was 2.4 (95% confidence interval [CI]: 2.2-2.7). We found that 474 infants (16%) with cardiovascular malformations were born at <37 weeks of gestation, giving an OR for prematurity among infants with a cardiovascular malformation of 2.4 (95% CI: 2.2-2.7). More infants were born preterm with diagnoses of pulmonary atresia with ventricular septal defect (23%), complete atrioventricular septal defect (22%), and coarctation of the aorta, tetralogy of Fallot, and pulmonary valve stenosis (each 20%). Fewer were born preterm with diagnoses of pulmonary atresia and intact ventricular septum (7%), transposition of the great arteries (8%), and single ventricle (9%). We found that 18% of infants with ventricular septal defect requiring surgery were preterm, compared with 13% in the nonsurgical group. Preterm infants with ventricular septal defect required surgery in 30% of cases, compared with 23% of term infants with ventricular septal defect. These figures show that the excess of cardiovascular malformations among preterm infants cannot be explained by greater ascertainment of minor ventricular septal defects. In our denominator population, 646 live-born infants were recognized as having trisomy 21, and gestational age data were available for 609. Of ...

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“…1,2 Other factors, such as the presence of noncardiac congenital anomalies, can increase the risk of death of infants with CHDs. [3][4][5] The presence of extracardiac anomalies is more prevalent in infants with CHDs.…”

Section: Introductionmentioning

confidence: 99%

“…1 Other factors that might affect morbidity and mortality, such as being small for gestational age (SGA) or having necrotizing enterocolitis, were also reported to be more prevalent in premature infants with CHDs. 2 Identification of risks for death is useful for perinatal counseling and in weighing risks and benefits of planned preterm delivery for complicated pregnancies. We evaluated the risk of death associated with late preterm birth (34 0/7 to 36 6/7 weeks) in infants with severe CHDs, and we hypothesized that late preterm birth independently subjects these infants to additional risks for death compared with birth at term.…”

Section: Introductionmentioning

confidence: 99%

The effect of late preterm birth on mortality of infants with major congenital heart defects

et al. 2011

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Objective: We evaluated the effect of late preterm delivery (34 to 36 weeks) on hospital mortality of infants with congenital heart defects (CHDs).Study Design: Retrospective record review of infants with major CHD born at or after to 34 weeks, cared for in a single tertiary perinatal center between 2002 and 2009. Factors associated with death before discharge from the hospital were ascertained using univariate and multivariate analyses.Result: Of the 753 infants with CHD, 117 were born at late preterm. Using logistic regression analysis, white race (OR; 95% CI) (0.60; 0.39 to 0.95), late preterm delivery (2.70; 1.69 to 4.33), and need for intubation in the delivery room (3.15; 1.92 to 5.17) were independently associated with hospital death. Conclusion:Late preterm birth of infants with major CHDs was independently associated with increased risk of hospital death compared with delivery at more mature gestational ages.

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Outcome of preterm infants with congenital heart disease

Cited by 99 publications

References 17 publications

The Association Between Major Birth Defects and Preterm Birth

The Association Between Major Birth Defects and Preterm Birth

Cardiovascular Malformations Among Preterm Infants

The effect of late preterm birth on mortality of infants with major congenital heart defects

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