Regional differences in right versus left congenital heart disease diagnoses in neonates in the United States

Nelson, Jennifer S.; Strassle, Paula D.

doi:10.1002/bdr2.1140

Cited by 6 publications

(2 citation statements)

References 38 publications

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“…On the other side, the South had the highest incidence of severe CHD in premature infants. The relative unavailability of antenatal screening for CHD and probably the lack of an opportunity to terminate pregnancy might have contributed to higher rates of CHD in preterm infants ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Neonatal outcomes in preterm infants with severe congenital heart disease: a national cohort analysis

Aly,

Qattea,

Kattea

et al. 2024

Front. Pediatr.

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BackgroundPrematurity and congenital heart disease (CHD) are the leading causes of neonatal mortality and morbidity. Limited data are available about the outcomes of premature infants with severe CHD.MethodsWe queried The National Inpatient Database using ICD-10 codes for premature patients (<37 weeks) with severe CHD from 2016 to 2020. Severe CHDs were grouped into three categories: A. left-sided lesions with impaired systemic output, B. Cyanotic CHD, and C. Shunt lesions with pulmonary overcirculation. Patients with isolated atrial or ventricular septal defects and patent ductus arteriosus were excluded. We also excluded patients with chromosomal abnormalities and major congenital anomalies. Patients' demographics, clinical characteristics, and outcomes were evaluated by comparing premature infants with vs. without CHD adjusting for gestational age (GA), birth weight, and gender.ResultsA total of 27710 (1.5%) out of 1,798,245 premature infants had severe CHD. This included 27%, 58%, and 15% in groups A, B, and C respectively. The incidence of severe CHD was highest between 25 and 28 weeks of gestation and decreased significantly with increasing GA up to 36 weeks (p < 0.001). Premature infants with severe CHD had a significantly higher incidence of neonatal morbidities including necrotizing enterocolitis (NEC) [OR = 4.88 (4.51–5.27)], interventricular hemorrhage [OR = 6.22 (5.57–6.95)], periventricular leukomalacia [OR = 3.21 (2.84–3.64)] and bronchopulmonary dysplasia [OR = 8.26 (7.50–10.06) compared to preterm infants of similar GA without CHD. Shunt lesions had the highest incidence of NEC (8.5%) compared to 5.3% in cyanotic CHD and 3.7% in left-sided lesions (p < 0.001). Mortality was significantly higher in premature infants with CHD compared to control [11.6% vs. 2.5%, p < 0.001]. Shunt lesions had significantly higher mortality (11.0%) compared to those with left-sided lesions (8.3%) and cyanotic CHD (6.4%), p < 0.001.ConclusionPremature infants with severe CHD are at high risk of neonatal morbidity and mortality. Morbidity remains increased across all GA groups and in all CHD categories. This significant risk of adverse outcomes is important to acknowledge when managing this patient population and when counseling their families. Future research is needed to examine the impact of specific rather than categorized congenital heart defects on neonatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Neonatal outcomes in preterm infants with severe congenital heart disease: a national cohort analysis

Aly,

Qattea,

Kattea

et al. 2024

Front. Pediatr.

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“…Researches have shown that CHD is a major risk factor for infant mortality associated with BD and can lead to chronic disability, morbidity and increased medical costs 3 – 5 . It was previously reported that the prevalence of CHD was highest in Asia, second highest in Europe, and lowest in Africa, reflecting significant geographic differences 6 – 8 . Although environmental and behavioral components play a crucial role in the etiological progression of BD, additional research is still required 9 – 11 .…”

Section: Introductionmentioning

confidence: 92%

Geographical variations in maternal lifestyles during pregnancy associated with congenital heart defects among live births in Shaanxi province, Northwestern China

Liu

Zhang

Jing

et al. 2020

Sci Rep

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In this study, we aimed to explore regional differences in maternal lifestyle during pregnancy related to congenital heart defects (cHD) in Shaanxi province, northwestern china. A large-scale epidemiologic survey of birth defects among infants born during 2010-2013, was conducted in Shaanxi province. non-spatial and geographic weighted logistic regression models were used for analysis. the spatial model indicated that passive smoking frequency was positively associated with CHD for 43.3% of participants (P < 0.05), with the highest OR in North Shaanxi and the lowest in South Shaanxi. Approximately 49.2% of all mothers who ever drink tea were more likely to have an infant with cHD (P < 0.05), with the highest OR values observed in North and Central Shaanxi. Additionally, maternal alcohol intake frequency ≥ 1/week was significantly correlated with CHD among about 24.7% of participants (P < 0.05), with OR values ranging from 0.738 (Central Shaanxi) to 1.198 (North Shaanxi). The rates of unhealthy maternal lifestyles during pregnancy associated with CHD differed in various areas of the province. the role of geographical variations in these factors may provide some possible clues and basis for tailoring site-specific intervention strategies. Congenital heart disease (CHD), a serious structural abnormality of the heart or large blood vessels in the intrathoracic, is one of the most common types of birth defects (BD) globally 1,2. Researches have shown that CHD is a major risk factor for infant mortality associated with BD and can lead to chronic disability, morbidity and increased medical costs 3-5. It was previously reported that the prevalence of CHD was highest in Asia, second highest in Europe, and lowest in Africa, reflecting significant geographic differences 6-8. Although environmental and behavioral components play a crucial role in the etiological progression of BD, additional research is still required 9-11. Over the years, numerous studies exploring risk factors for CHD have confirmed that maternal lifestyle-related factors such as smoking and alcohol intake during pregnancy may be responsible for certain categories of congenital defects 1,12-14. Because of socio-cultural and geographical reasons, maternal lifestyle-related factors in pregnancy may be different and population-specific in each area. Study results related to associations of maternal lifestyle factors with CHD have not always been consistent across regions 15. These conflicting results may in part stem from geographic heterogeneity, which would lead to bias in correlation estimates and associated calculations of standard error. In China, the incidence rate of CHD is the highest among BD, and the surgical treatment of CHD infants is estimated to cost 12 billion Yuan per year 16. Our previous study found that the Shaanxi province, which accounts

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Trends in incidence and outcomes of gastroschisis in the United States: analysis of the national inpatient sample 2010–2014

et al. 2018

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Regional differences in right versus left congenital heart disease diagnoses in neonates in the United States

Abstract: The prevalence of CHD diagnoses at birth in the US has increased, and regional differences in the prevalence of right defects appear to exist.

Cited by 6 publications

References 38 publications

Neonatal outcomes in preterm infants with severe congenital heart disease: a national cohort analysis

Neonatal outcomes in preterm infants with severe congenital heart disease: a national cohort analysis

Geographical variations in maternal lifestyles during pregnancy associated with congenital heart defects among live births in Shaanxi province, Northwestern China

Trends in incidence and outcomes of gastroschisis in the United States: analysis of the national inpatient sample 2010–2014

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