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01.06.2013 | Pediatric Original

Increased morbidity and mortality in very preterm/VLBW infants with congenital heart disease

verfasst von: Angelo Polito, Simone Piga, Paola E. Cogo, Carlo Corchia, Virgilio Carnielli, Monica Da Frè, Domenico Di Lallo, Isabella Favia, Luigi Gagliardi, Francesco Macagno, Silvana Miniaci, Marina Cuttini

Erschienen in: Intensive Care Medicine | Ausgabe 6/2013

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Abstract

Purpose

To study the association between congenital heart diseases (CHD) and in-hospital mortality and morbidity of very preterm/very low birth weight (VLBW) infants.

Methods

The area-based prospective cohort study ACTION included all infants with gestational age (GA) 22–31 weeks or birth weight <1,500 g admitted to neonatal care between July 2003 and June 2005 in six Italian regions (n = 3,684). CHD were coded according to ICD9-CM. Cluster multivariable logistic regression analyses were used to assess the relationship between CHD and mortality and selected morbidities [neonatal infection, ultrasound brain abnormalities, retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD)] adjusting for potential confounders.

Results

Seventy-one patients had CHD [19.3 ‰, 95 % confidence interval (CI) 15.1–24.2 ‰]. The most common lesions were isolated atrial and ventricular septal defects (31.1 and 26.8 %, respectively), pulmonary valvar stenosis (12.7 %), and tetralogy of Fallot (5.6 %). Compared with other infants, CHD patients showed significantly higher GA and frequency of small for gestational age (SGA, i.e., birth weight ≤3rd centile). After adjustment for GA, sex, SGA, presence of extracardiac malformations or chromosomal anomalies, and region of birth, CHD patients had a significantly higher likelihood of infection, BPD, ROP, and, after 27 weeks gestation only, hospital mortality. The increased risk of ROP appeared to be partly due to infection.

Conclusions

In very preterm/VLBW infants CHD are more prevalent than in the general liveborn population, and confer an increased risk of death and serious morbidities independently of other risk factors. These results may be useful to better tailor prognostic assessment and diagnostic and therapeutic interventions for these children.

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Titel: Increased morbidity and mortality in very preterm/VLBW infants with congenital heart disease
verfasst von: Angelo Polito
Simone Piga
Paola E. Cogo
Carlo Corchia
Virgilio Carnielli
Monica Da Frè
Domenico Di Lallo
Isabella Favia
Luigi Gagliardi
Francesco Macagno
Silvana Miniaci
Marina Cuttini
Publikationsdatum: 01.06.2013
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 6/2013
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-2887-y

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Increased morbidity and mortality in very preterm/VLBW infants with congenital heart disease