Risk Factors for Mortality in Children with Congenital Heart Disease Delivered at a Brazilian Tertiary Center

Abstract

ObjectiveThis study aims to investigate the incidence of postnatal diagnosis of congenital heart disease (CHD) and the predictive factors for hospital mortality.MethodsThis retrospective cohort study was conducted at a Brazilian tertiary center, and data were collected from medical records with inclusion criteria defined as any newborn with CHD diagnosed in the postnatal period delivered between 2015 and 2017. Univariate and multivariate analyses were performed to determine the potential risk factors for mortality.ResultsDuring the 3-year period, 119 (5.3%) children of the 2215 children delivered at our institution were diagnosed with CHD. We considered birth weight (P=0.005), 1st min Apgar score (P=0.001), and CHD complexity (P=0.013) as independent risk factors for in-hospital mortality. The most common CHD was ventricular septal defect. Indeed, 60.5% cases were considered as "complex" or "significant" CHDs. Heart surgeries were performed on 38.9% children, 15 of whom had "complex" or "significant" CHD. A mortality rate of 42% was observed in this cohort, with 28% occurring within the initial 24 h after delivery and 38% occurring in patients admitted for heart surgery.ConclusionThe postnatal incidence of CHD at our service was 5.3%. Low 1st min Apgar score, low birth weight, and CHD complexity were the independent factors that affected the hospital outcome.

Associated Factors with Congenital Heart Disease in the Most Populated State of Brazil Between 2010 and 2018

“…Prematurity was directly related to the outcome, which agrees with the study of Rocha et al 20 It should be highlighted that the formation of the heart is complete around the eighth week of gestation 2 and that premature delivery alone is not directly related to most of the malformations. It is likely that the presence of CHD may function as a determining factor of preterm delivery, as shown by Laas and collaborators.…”

“…It is likely that the presence of CHD may function as a determining factor of preterm delivery, as shown by Laas and collaborators. Regarding advanced maternal age (34-49 years of age) as a factor associated with CHDs, other studies 16,17,12,20,22 give support to our results. This can be attributed to the greater tendency of genetic alterations with consequent chromosomal syndromes in children of this mother's age group, which are usually associated with a higher incidence of CHDs, as occurs in the trisomy 21 chromosome, for example.…”

Morbidity and mortality in premature or low birth weight patients with congenital heart disease in three European pediatric heart centers between 2016 and 2020

“…As described by others, the severity of CHD is an important factor affecting mortality in both term and preterm patients ( 17 , 18 ). We found severe CHD to be associated with worse outcomes, but no evidence for differences between simple and moderate CHD.…”

Clinical Pattern and Malnutrition among Children with Congenital Heart Disease at Tertiary Care Hospital

“…The prevalence of PEM was comparable to other studies' findings. Raissadati et al [20] found that FTT was 11.9% among children and Rocha et al [21] reported that 40% was the incidence of malnutrition. According to Latal et al [22] the incidence of malnutrition was 92% among children with CHD's in comparison to other studies [23,24].…”