Ten-Year Review of Major Birth Defects in VLBW Infants

Ira ADAMS-CHAPMAN; Nellie I HANSEN; Krisa P VAN MEURS; Abhik DAS; Ellen C HALE; Nancy S NEWMAN; M Bethany Ball; Rosemary D HIGGINS; Barbara J STOLL; Seetha SHANKARAN; Edward F BELL; Nansi S BOGHOSSIAN; Jeffrey C MURRAY; Abbot R LAPTOOK; Michele C WALSH; Waldemar A CARLO; Pablo J SANCHEZ

doi:10.1542/peds.2012-3111

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Ten-Year Review of Major Birth Defects in VLBW Infants

Journal article

Open access

Peer reviewed

Ten-Year Review of Major Birth Defects in VLBW Infants

Ira ADAMS-CHAPMAN, Nellie I HANSEN, Krisa P VAN MEURS, Abhik DAS, Ellen C HALE, Nancy S NEWMAN, M Bethany Ball, Rosemary D HIGGINS, Barbara J STOLL, Seetha SHANKARAN, …

Pediatrics (Evanston), Vol.132(1), pp.49-61

2013

DOI: 10.1542/peds.2012-3111

PMCID: PMC3691532

PMID: 23733791

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https://doi.org/10.1542/peds.2012-3111View

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Abstract

OBJECTIVE: Birth defects (BDs) are an important cause of infant mortality and disproportionately occur among low birth weight infants. We determined the prevalence of BDs in a cohort of very low birth weight (VLBW) infants cared for at the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers over a 10-year period and examined the relationship between anomalies, neonatal outcomes, and surgical care. METHODS: Infant and maternal data were collected prospectively for infants weighing 401 to 1500 g at NRN sites between January 1, 1998, and December 31, 2007. Poisson regression models were used to compare risk of outcomes for infants with versus without BDs while adjusting for gestational age and other characteristics. RESULTS: A BD was present in 1776 (4.8%) of the 37 262 infants in our VLBW cohort. Yearly prevalence of BDs increased from 4.0% of infants born in 1998 to 5.6% in 2007, P < .001. Mean gestational age overall was 28 weeks, and mean birth weight was 1007 g. Infants with BDs were more mature but more likely to be small for gestational age compared with infants without BDs. Chromosomal and cardiovascular anomalies were most frequent with each occurring in 20% of affected infants. Mortality was higher among infants with BDs (49% vs 18%; adjusted relative risk: 3.66 [95% confidence interval: 3.41–3.92]; P < .001) and varied by diagnosis. Among those surviving >3 days, more infants with BDs underwent major surgery (48% vs 13%, P < .001). CONCLUSIONS: Prevalence of BDs increased during the 10 years studied. BDs remain an important cause of neonatal morbidity and mortality among VLBW infants.

Gynecology. Andrology. Obstetrics

Biological and medical sciences

General aspects

Pregnancy. Fetus. Placenta

Medical sciences

Diseases of mother, fetus and pregnancy

Details

Title: Subtitle: Ten-Year Review of Major Birth Defects in VLBW Infants
Creators: Ira ADAMS-CHAPMAN - Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia, United States
Nellie I HANSEN - Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina, United States
Krisa P VAN MEURS - Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California, United States
Abhik DAS - Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland, United States
Ellen C HALE - Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia, United States
Nancy S NEWMAN - Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, United States
M Bethany Ball - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
Rosemary D HIGGINS - Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States
Barbara J STOLL - Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia, United States
Seetha SHANKARAN - Department of Pediatrics, Wayne State University, Detroit, Michigan, United States
Edward F BELL - Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States
Nansi S BOGHOSSIAN - Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States
Jeffrey C MURRAY - Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States
Abbot R LAPTOOK - Department of Pediatrics, Women & Infants' Hospital, Brown University, Providence, Rhode Island, United States
Michele C WALSH - Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, United States
Waldemar A CARLO - Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama, United States
Pablo J SANCHEZ - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.132(1), pp.49-61
DOI: 10.1542/peds.2012-3111
PMID: 23733791
PMCID: PMC3691532
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics; Elk Grove Village, IL
Language: English
Date published: 2013
Academic Unit: Anatomy and Cell Biology; Stead Family Department of Pediatrics; Epidemiology; Pediatric Dentistry; Craniofacial Anomalies Research Center; Dental Research; Neonatology
Record Identifier: 9984025302002771

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