Preterm Birth and Congenital Heart Defects: A Population-based Study

Laas, Enora; Lelong, Nathalie; Thieulin, Anne‐Claire; Houyel, Lucile; Bonnet, Damien; Ancel, Pierre‐Yves; Kayem, Gilles; Goffinet, François; Khoshnood, Babak

doi:10.1542/peds.2011-3279

Cited by 86 publications

(69 citation statements)

References 40 publications

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“…Nonetheless these relatively smaller differences would not change our overall conclusion that severe CHDs are strongly associated with very/extremely premature birth. This conclusion is consistent with the findings of Laas et al who demonstrated that European children with CHDs (excluding ASDs and PDAs) were twice as likely to be born prematurely (<37 weeks GA) or very/extremely prematurely (<32 weeks GA) than children without CHDs 20 . Importantly in our analysis the relative prevalence of severe CHDs was even higher at earlier GAs.…”

Section: Discussionsupporting

confidence: 92%

“…Again there are similarities between our data and the findings of Laas et al who demonstrated that the subset of single ventricle anomalies were most strongly associated with preterm birth while pulmonary venous anomalies were the only defects with higher birth prevalence in term neonates 20 . Interestingly we also found that pulmonary venous anomalies were more common in term neonates and we had adequate sample size to look at specific subsets of single ventricle anomalies, finding that HLHS was most strongly associated with very/extreme premature birth.…”

Section: Discussionsupporting

confidence: 90%

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Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age

Chu

Kosinski

et al. 2017

The Journal of Pediatrics

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Objective To determine the birth prevalence of congenital heart defects (CHDs) across the spectrum of common defects in very/extremely premature infants and to compare mortality rates between premature infants with and without CHDs. Study design The Kids' Inpatient Databases (2003-2012) were used to estimate the birth prevalence of CHDs (excluding patent ductus arteriosus) in very/extremely premature infants born between 25 and 32 weeks gestational age (GA). Birth prevalence was compared with term infants for a subset of “severe” defects expected to be near universally diagnosed in the neonatal period. Weighted multivariable logistic regression was used to calculate adjusted odds ratios of mortality comparing very and extremely premature infants with versus without CHDs. Results We identified 249,011 very/extremely premature infants, including 28,806 with CHDs. The overall birth prevalence of CHDs was 116 per 1000 very/extremely premature births. Severe CHDs had significantly higher birth prevalence in very/extremely premature infants when compared with term infants (7.4 per 1000 very/premature births versus 1.5 per 1000 term births, p<0.001). Very/extremely premature infants with severe CHDs had an overall 26.3% in-hospital mortality and a 7.5-fold increased adjusted odds of death compared with those without CHDs. Mortality varied widely by defect in very/extremely premature infants, ranging from 12% for interrupted aortic arch to 67% for truncus arteriosus. Conclusion Given the increased birth prevalence of severe CHDs in very/extremely premature infants, and significantly higher mortality, there is justification for intensive interventions aimed at decreasing the likelihood of premature delivery for patients where CHD is diagnosed in utero.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age

Chu

Kosinski

et al. 2017

The Journal of Pediatrics

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“…CHD fetuses are at a high risk of spontaneous preterm birth 81 . Preterm birth in CHD impacts mortality, morbidity and neurodevelopmental outcomes 82, 83 .…”

Section: Similarities and Differences To The Preterm Populationmentioning

confidence: 99%

Neurodevelopmental Abnormalities and Congenital Heart Disease

Morton

Ishibashi

Jonas

2017

Circulation Research

146

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In the past two decades it has become evident that individuals born with congenital heart disease (CHD) are at risk of developing life-long neurological deficits. Multifactorial risk factors contributing to neurodevelopmental abnormalities associated with CHD have been identified; however the underlying etiologies remain largely unknown and efforts to address this issue have only recently begun. There has been a dramatic shift in focus from newly acquired brain injuries associated with corrective and palliative heart surgery to antenatal and preoperative factors governing altered brain maturation in CHD. In this review, we describe key time windows of development during which the immature brain is vulnerable to injury. Special emphasis is placed on the dynamic nature of cellular events and how CHD may adversely impact the cellular units and networks necessary for proper cognitive and motor function. In addition, we describe current gaps in knowledge and offer perspectives about what can be done to improve our understanding of neurological deficits in CHD. Ultimately, a multidisciplinary approach will be essential in order to prevent or improve adverse neurodevelopmental outcomes in individuals surviving CHD.

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“…With this increase, the need for echocardiographic reference values increases equally. Newborns with congenital heart disease have a two-fold higher risk of (spontaneous) preterm birth than the general population [2]. Low birth weight (BW) has been established as a factor associated with the development of congenital heart disease [3].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Valve Annulus Diameters in Extremely Preterm Infants: A Cross-Sectional Echocardiographic Study

et al. 2018

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Background: With the increasing incidence of births of very preterm very-low-birth-weight infants, there is a demand for echocardiographic reference values of cardiac dimensions. Objectives: The aim of this study was to provide reference values of cardiac valve annulus diameters in a cohort of extremely preterm very-low-birth-weight neonates and to correlate these with patient characteristics. Methods: Valve diameters of 376 infants of < 32 weeks’ gestation and with a birth weight of ≤2,000 g were measured using 2-dimensional echocardiography. Correlations between valve diameters and patient characteristics (birth length/weight, body surface area, gestational age, and sex) were assessed. Birth weight was used to establish linear regression models. Inter- and intraobserver agreement was assessed through intraclass correlation coefficient (ICC) analysis. Results: Substantial variability was found (aortic valve mean [standard deviation; range]: 5.0 mm [0.6; 3.7–6.5]; pulmonic valve: 5.8 mm [0.8; 3.4–7.9]; mitral valve: 8.0 mm [1.0; 5.5–10.5]; tricuspid valve: 7.6 mm [1.2; 4.9–10.6]). There was a moderate correlation between birth weight and valve diameter (R² aortic valve: 0.36; pulmonic valve: 0.20; mitral valve: 0.24; tricuspid valve: 0.24). Adequate intraobserver (ICC range 0.74–0.91) and interobserver agreement (ICC range 0.77–0.89) was found. Conclusions: Our study provides ready-to-use reference values for cardiac valve annulus diameters for extremely preterm infants.

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Preterm Birth and Congenital Heart Defects: A Population-based Study

Abstract: We found a higher risk of PTB in newborns with CHD, which was essentially due to spontaneous PTB. Risk of PTB varied for categories of CHD. Our finding may be helpful for generating hypotheses about the developmental links between CHD and PTB.

Cited by 86 publications

References 40 publications

Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age

Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age

Neurodevelopmental Abnormalities and Congenital Heart Disease

Cardiac Valve Annulus Diameters in Extremely Preterm Infants: A Cross-Sectional Echocardiographic Study

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