Korean J Pediatr.  2009 Apr;52(4):481-487. 10.3345/kjp.2009.52.4.481.

Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants

• Yoo HS
• Kim JE
• Park SK
• Seo HJ
• Jeong YJ
• Chio SH
• Jeong SI
• Kim SH
• Yang JH
• Huh J
• Chang YS
• Jun TG
• Kang IS
• Park WS
• Park PW
• Lee HJ

• KMID: 2281750
• DOI: http://doi.org/10.3345/kjp.2009.52.4.481

Abstract

PURPOSE
This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). METHODS: Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). RESULTS: The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (> or =Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). CONCLUSION: The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.

Keyword

Infant; Very Low Birth Weight; Congenital Heart Defects; Congenital Abnormalities; Chromosome Disorders

MeSH Terms

Birth Weight
Bronchopulmonary Dysplasia
Chromosome Disorders
Congenital Abnormalities
Early Intervention (Education)
Enterocolitis, Necrotizing
Fetal Growth Retardation
Gestational Age
Heart Defects, Congenital
Heart Septal Defects, Ventricular
Hemorrhage
Humans
Incidence
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Leukomalacia, Periventricular
Medical Records
Prognosis
Retrospective Studies
Thoracic Surgery