Korean Circ J.  2020 Dec;50(12):1113-1123. 10.4070/kcj.2020.0135.

Morbidity and Mortality of Very Low Birth Weight Infants with Congenital Heart Disease

Affiliations
  • 1Department of Pediatrics, University of Eulji College of Medicine, Daejeon, Korea
  • 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
  • 3Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, Seoul, Korea

Abstract

Background and Objectives
This study aimed to provide morbidity and mortality information on very low birth weight (VLBW) infants with congenital heart disease (CHD-VLBWs).
Methods
The study used a 10-year cohort of VLBW infants from a single institution. CHD was classified according to International Classification of Diseases, Version 9, Clinical Modification. Mortality and neonatal outcomes were assessed by comparing the CHD-VLBWs with gestational age- and birth weight-matched controls.
Results
The prevalence of CHD-VLBWs was 7.5% (79/1,050), mean gestational age was 31.1±3.2 weeks, and mean birth weight was 1,126.2±268.3 g; 50.6% of the infants were small for the gestational age. The CHD-VLBWs more commonly had bronchopulmonary dysplasia (BPD), and the longer they were exposed to oxygen, the more frequently they developed BPD. Those with cyanotic heart disease developed severe BPD more frequently. Necrotizing enterocolitis (NEC) occurred frequently in the CHD-VLBWs and was not associated with their feeding patterns. CHD-VLBWs had a higher mortality rate; prematurity-related diseases were the leading cause of death before surgery, while heart-related problems were the leading cause of death after surgery. We found no significant difference in mortality from prematurity-related disease between the CHD-VLBWs and controls. In the subgroup analysis of CHD, the cyanotic CHD group had a higher incidence of BPD and higher mortality rate than the acyanotic CHD group.
Conclusions
CHD-VLBWs showed higher BPD, NEC, and mortality rates than those without CHD. There was also a higher incidence of BPD and mortality in VLBW infants with cyanotic CHD than in those with acyanotic CHD.

Keyword

Congenital heart defect; Preterm infants; Very-low-birth-weight infant; Bronchopulmonary dysplasia; Necrotizing enterocolitis

Figure

  • Figure 1 Study population eligibility and enrollment.


Cited by  1 articles

Congenital Heart Disease in Premature Infants Less than 1,500 grams: It Takes a Delicate Touch from Many Multidisciplinary Experts
Jin-Hee Oh
Korean Circ J. 2020;50(12):1124-1126.    doi: 10.4070/kcj.2020.0426.


Reference

1. Moons P, Sluysmans T, De Wolf D, et al. Congenital heart disease in 111 225 births in Belgium: birth prevalence, treatment and survival in the 21st century. Acta Paediatr. 2009; 98:472–477. PMID: 19046347.
2. Tanner K, Sabrine N, Wren C. Cardiovascular malformations among preterm infants. Pediatrics. 2005; 116:e833–8. PMID: 16322141.
Article
3. Kecskes Z, Cartwright DW. Poor outcome of very low birthweight babies with serious congenital heart disease. Arch Dis Child Fetal Neonatal Ed. 2002; 87:F31–3. PMID: 12091287.
Article
4. Lopes SAVDA, Guimarães ICB, Costa SFO, Acosta AX, Sandes KA, Mendes CMC. Mortality for critical congenital heart diseases and associated risk factors in newborns. a cohort study. Arq Bras Cardiol. 2018; 111:666–673. PMID: 30281694.
5. Fisher JG, Bairdain S, Sparks EA, et al. Serious congenital heart disease and necrotizing enterocolitis in very low birth weight neonates. J Am Coll Surg. 2015; 220:1018–1026.e14. PMID: 25868405.
Article
6. Pappas A, Shankaran S, Hansen NI, et al. Outcome of extremely preterm infants (<1,000 g) with congenital heart defects from the National Institute of Child Health and Human Development Neonatal Research Network. Pediatr Cardiol. 2012; 33:1415–1426. PMID: 22644414.
7. Shim SY, Cho SJ, Kong KA, Park EA. Gestational age-specific sex difference in mortality and morbidities of preterm infants: a nationwide study. Sci Rep. 2017; 7:6161. PMID: 28733681.
Article
8. D'Alto M, Budts W, Diller GP, et al. Does gender affect the prognosis and risk of complications in patients with congenital heart disease in the modern era? Int J Cardiol. 2019; 290:156–161. PMID: 31085083.
9. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013; 13:59. PMID: 23601190.
Article
10. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163:1723–1729. PMID: 11401896.
Article
11. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986; 33:179–201. PMID: 3081865.
Article
12. Simpson C, Schanler RJ, Lau C. Early introduction of oral feeding in preterm infants. Pediatrics. 2002; 110:517–522. PMID: 12205253.
Article
13. Salas AA, Kabani N, Travers CP, Phillips V, Ambalavanan N, Carlo WA. Short versus extended duration of trophic feeding to reduce time to achieve full enteral feeding in extremely preterm infants: an observational study. Neonatology. 2017; 112:211–216. PMID: 28704816.
Article
14. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978; 92:529–534. PMID: 305471.
Article
15. An international classification of retinopathy of prematurity. The Committee for the Classification of Retinopathy of Prematurity. Arch Ophthalmol. 1984; 102:1130–1134. PMID: 6547831.
16. Polito A, Piga S, Cogo PE, et al. Increased morbidity and mortality in very preterm/VLBW infants with congenital heart disease. Intensive Care Med. 2013; 39:1104–1112. PMID: 23536167.
Article
17. Speer CP. Pulmonary inflammation and bronchopulmonary dysplasia. J Perinatol. 2006; 26(Suppl 1):S57–S62. PMID: 16625227.
Article
18. Alrddadi SM, Morsy MM, Albakri JK, et al. Risk factors for prolonged mechanical ventilation after surgical repair of congenital heart disease. Experience from a single cardiac center. Saudi Med J. 2019; 40:367–371. PMID: 30957130.
19. Shi S, Zhao Z, Liu X, et al. Perioperative risk factors for prolonged mechanical ventilation following cardiac surgery in neonates and young infants. Chest. 2008; 134:768–774. PMID: 18625673.
Article
20. Norman M, Håkansson S, Kusuda S, et al. Neonatal outcomes in very preterm infants with severe congenital heart defects: an international cohort study. J Am Heart Assoc. 2020; 9:e015369. PMID: 32079479.
21. Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011; 364:255–264. PMID: 21247316.
Article
22. Giannone PJ, Luce WA, Nankervis CA, Hoffman TM, Wold LE. Necrotizing enterocolitis in neonates with congenital heart disease. Life Sci. 2008; 82:341–347. PMID: 18187159.
Article
23. Bain J, Benjamin DK Jr, Hornik CP, Benjamin DK, Clark R, Smith PB. Risk of necrotizing enterocolitis in very-low-birth-weight infants with isolated atrial and ventricular septal defects. J Perinatol. 2014; 34:319–321. PMID: 24434778.
Article
24. Battersby C, Santhalingam T, Costeloe K, Modi N. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2018; 103:F182–9. PMID: 29317459.
Article
25. Henderson G, Craig S, Brocklehurst P, McGuire W. Enteral feeding regimens and necrotising enterocolitis in preterm infants: a multicentre case-control study. Arch Dis Child Fetal Neonatal Ed. 2009; 94:F120–3. PMID: 17768154.
Article
26. Kawahira Y, Nishigaki K, Maehata Y. Bilateral pulmonary artery banding for extremely low birth weight infants with coarctation or interruption of the aorta weighing less than 1.0 kg. J Thorac Cardiovasc Surg. 2010; 139:1339–1340. PMID: 19919866.
Article
27. Rios R, Dummer KB, Overman DM. Successful staged surgical repair using rapid pulmonary artery banding in a very-low-birth-weight premature infant who had d-transposition of the great arteries with an intact ventricular septum. Pediatr Cardiol. 2013; 34:1935–1937. PMID: 22903681.
Article
28. Nam HK, Lee KH. Small for gestational age and obesity: epidemiology and general risks. Ann Pediatr Endocrinol Metab. 2018; 23:9–13. PMID: 29609444.
Article
29. Dollat C, Vergnat M, Laux D, et al. Critical congenital heart diseases in preterm neonates: is early cardiac surgery quite reasonable? Pediatr Cardiol. 2015; 36:1279–1286. PMID: 25854847.
Article
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