Outcome of Extremely Low Birth Weight Infants with Congenital Heart Defects in the Eunice Kennedy Shriver NICHD Neonatal Research Network

• Type of Material: Article
• Authors: Athina Pappas, Wayne State University; Seetha Shankaran, Wayne State University; Nellie I. Hansen, RTI International; Edward F. Bell, University of Iowa; Barbara Stoll, Emory University; Abbot R. Laptook, Brown University; Michele C. Walsh, Case Western Reserve University; Abhik Das, RTI International; Rebecca Bara, Wayne State University; Ellen C. Hale, Emory University; Nancy S. Newman, Case Western Reserve University; Nancy S. Boghossian, Eunice Kennedy Shriver National Institute of Child Health and Human Development; Jeffery C. Murray, University of Iowa; C. Michael Cotten, Duke University; Ira Adams-Chapman, Emory University; Shannon Hamrick, Emory University; Rosemary D. Higgins, Eunice Kennedy Shriver National Institute of Child Health and Human Development
• Language: English
• Date: 2012-12-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Springer Science+Business Media, LLC.
• Final Published Version (URL): http://dx.doi.org/10.1007/s00246-012-0375-8
• Title of Journal or Parent Work: Pediatric Cardiology
• ISSN: 0172-0643
• Volume: 33
• Issue: 8
• Start Page: 1415
• End Page: 1426
• Grant/Funding Information: The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network’s Generic Database Study and Follow-up Study.; The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• Keywords: Cardiac & Cardiovascular Systems; VALVULOPLASTY; DISEASE; Extremely low birth weight; SURGERY; Cardiovascular System & Cardiology; EXPERIENCE; Science & Technology; LOW-BIRTH-WEIGHT; Neurodevelopmental follow-up; Life Sciences & Biomedicine; Congenital heart defects; Pediatrics; MORTALITY; FETUSES
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

Little is known about the outcomes of extremely low birth weight (ELBW) preterm infants with congenital heart defects (CHDs). The aim of this study was to assess the mortality, morbidity, and early childhood outcomes of ELBW infants with isolated CHD compared with infants with no congenital defects. Participants were 401-1,000 g infants cared for at National Institute of Child Health and Human Development Neonatal Research Network centers between January 1, 1998, and December 31, 2005. Neonatal morbidities and 18-22 months' corrected age outcomes were assessed. Neurodevelopmental impairment (NDI) was defined as moderate to severe cerebral palsy, Bayley II mental or psychomotor developmental index < 70, bilateral blindness, or hearing impairment requiring aids. Poisson regression models were used to estimate relative risks for outcomes while adjusting for gestational age, small-for-gestational-age status, and other variables. Of 14,457 ELBW infants, 110 (0.8 %) had isolated CHD, and 13,887 (96 %) had no major birth defect. The most common CHD were septal defects, tetralogy of Fallot, pulmonary valve stenosis, and coarctation of the aorta. Infants with CHD experienced increased mortality (48 % compared with 35 % for infants with no birth defect) and poorer growth. Surprisingly, the adjusted risks of other short-term neonatal morbidities associated with prematurity were not significantly different. Fifty-seven (52 %) infants with CHD survived to 18-22 months' corrected age, and 49 (86 %) infants completed follow-up. A higher proportion of surviving infants with CHD were impaired compared with those without birth defects (57 vs. 38 %, p = 0.004). Risk of death or NDI was greater for ELBW infants with CHD, although 20 % of infants survived without NDI.