J Korean Soc Neonatol.  2011 Nov;18(2):221-227. 10.5385/jksn.2011.18.2.221.

Identification of Characteristics and Risk Factors Associated with Mortality in Hydrops Fetalis

Affiliations
  • 1Department of Pediatrics, Division of Neonatology, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. arkim@amc.seoul.kr
  • 2Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The objectives were to identify the characteristics of neonates with hydrops fetalis, and to identify the risk factors associated with mortality.
METHODS
A retrospective review of AMC (Asan Medical Center) dataset was performed from January 1990 to June 2009. The characteristics of 71 patients with hydrops fetalis were investigated and they were divided into two groups: the survived group and the expired group. Various perinatal and neonatal factors in two groups were compared to find out risk factors associated with mortality based on univariate analysis, followed by multiple regression analyses (SPSS version 18.0).
RESULTS
Of those 71 neonates (average gestational age: 33 weeks, birth weight: 2.6 kg), 38 survived, 33 died, resulting in overall mortality rate of 46.5%. The most common etiology was idiopathic followed by chylothorax, cardiac anomalies, twin-to-twin transfusion, meconium peritonitis, cardiac arrythmias, and congenital infections. Factors that were associated independently with mortality in logistic regression analyses were low 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days.
CONCLUSION
In this study, 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days were significant risk factors associated with mortality in hydrops fetalis. Therefore, the risk of death among neonates with hydrops fetalis depends on the illness immediately after birth and severity of hydrops fetalis. Informations from this study may prove useful in prediction of prognosis to neonates with hydrops fetalis.

Keyword

Hydrops fetalis; Mortality; Risk factor

MeSH Terms

Apgar Score
Arrhythmias, Cardiac
Chylothorax
Edema
Gestational Age
Humans
Hyaline Membrane Disease
Hydrops Fetalis
Ideal Body Weight
Infant, Newborn
Logistic Models
Meconium
Parturition
Peritonitis
Prognosis
Retrospective Studies
Risk Factors
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