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

Athina Pappas; Seetha Shankaran; Nellie Hansen; Edward Bell; Barbara Stoll; Abbot Laptook; Michele Walsh; Abhik Das; Rebecca Bara; Ellen Hale; Nancy Newman; Nansi Boghossian; Jeffrey Murray; C Cotten; Ira Adams-Chapman; Shannon Hamrick; Rosemary Higgins

doi:10.1007/s00246-012-0375-8

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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

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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

Athina Pappas, Seetha Shankaran, Nellie Hansen, Edward Bell, Barbara Stoll, Abbot Laptook, Michele Walsh, Abhik Das, Rebecca Bara, Ellen Hale, …

Pediatric cardiology, Vol.33(8), pp.1415-1426

12/2012

DOI: 10.1007/s00246-012-0375-8

PMCID: PMC3687358

PMID: 22644414

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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.

Vascular Surgery

Cardiology

Extremely low birth weight

Medicine & Public Health

Cardiac Surgery

Neurodevelopmental follow-up

Congenital heart defects

Details

Title: Subtitle: 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
Creators: Athina Pappas - Department of Pediatrics, Children’s Hospital of Michigan and Hutzel Women’s Hospital Wayne State University 3901 Beaubien Detroit MI 48201 USA
Seetha Shankaran - Department of Pediatrics, Children’s Hospital of Michigan and Hutzel Women’s Hospital Wayne State University 3901 Beaubien Detroit MI 48201 USA
Nellie Hansen - Statistics and Epidemiology Unit RTI International Research Triangle Park NC 27709 USA
Edward Bell - Department of Pediatrics University of Iowa Iowa City IA 52242 USA
Barbara Stoll - Department of Pediatrics Emory University School of Medicine and Children’s Healthcare of Atlanta Atlanta GA 30303 USA
Abbot Laptook - Department of Pediatrics, Women & Infants’ Hospital Brown University Providence RI 02905 USA
Michele Walsh - Department of Pediatrics, Rainbow Babies & Children’s Hospital Case Western Reserve University Cleveland OH 44106 USA
Abhik Das - Statistics and Epidemiology Unit RTI International Rockville MD 20852 USA
Rebecca Bara - Department of Pediatrics, Children’s Hospital of Michigan and Hutzel Women’s Hospital Wayne State University 3901 Beaubien Detroit MI 48201 USA
Ellen Hale - Department of Pediatrics Emory University School of Medicine and Children’s Healthcare of Atlanta Atlanta GA 30303 USA
Nancy Newman - Case Western Reserve University
Nansi Boghossian - Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD 20852 USA
Jeffrey Murray - Department of Pediatrics University of Iowa Iowa City IA 52242 USA
C Cotten - Department of Pediatrics Duke University Durham NC 27710 USA
Ira Adams-Chapman - Department of Pediatrics Emory University School of Medicine and Children’s Healthcare of Atlanta Atlanta GA 30303 USA
Shannon Hamrick - Department of Pediatrics Emory University School of Medicine and Children’s Healthcare of Atlanta Atlanta GA 30303 USA
Rosemary Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD 20852 USA
Resource Type: Journal article
Publication Details: Pediatric cardiology, Vol.33(8), pp.1415-1426
DOI: 10.1007/s00246-012-0375-8
PMID: 22644414
PMCID: PMC3687358
NLM abbreviation: Pediatr Cardiol
ISSN: 0172-0643
eISSN: 1432-1971
Publisher: Springer-Verlag; New York
Language: English
Date published: 12/2012
Academic Unit: Anatomy and Cell Biology; Stead Family Department of Pediatrics; Epidemiology; Pediatric Dentistry; Craniofacial Anomalies Research Center; Dental Research; Neonatology
Record Identifier: 9984025313702771

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