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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• 作者：Athina Pappas (1)
  Seetha Shankaran (1)
  Nellie I. Hansen (2)
  Edward F. Bell (3)
  Barbara J. Stoll (4)
  Abbot R. Laptook (5)
  Michele C. Walsh (6)
  Abhik Das (7)
  Rebecca Bara (1)
  Ellen C. Hale (4)
  Nancy S. Newman (6)
  Nansi S. Boghossian (8)
  Jeffrey C. Murray (3)
  C. Michael Cotten (9)
  Ira Adams-Chapman (4)
  Shannon Hamrick (4)
  Rosemary D. Higgins (8)
  
• 关键词：Congenital heart defects ; Extremely low birth weight ; Neurodevelopmental follow ; up
• 刊名：Pediatric Cardiology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：33
• 期：8
• 页码：1415-1426
• 全文大小：212KB
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• 作者单位：Athina Pappas (1)
  Seetha Shankaran (1)
  Nellie I. Hansen (2)
  Edward F. Bell (3)
  Barbara J. Stoll (4)
  Abbot R. Laptook (5)
  Michele C. Walsh (6)
  Abhik Das (7)
  Rebecca Bara (1)
  Ellen C. Hale (4)
  Nancy S. Newman (6)
  Nansi S. Boghossian (8)
  Jeffrey C. Murray (3)
  C. Michael Cotten (9)
  Ira Adams-Chapman (4)
  Shannon Hamrick (4)
  Rosemary D. Higgins (8)
  
  1. Department of Pediatrics, Children’s Hospital of Michigan and Hutzel Women’s Hospital, Wayne State University, 3901 Beaubien, Detroit, MI, 48201, USA
  2. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, 27709, USA
  3. Department of Pediatrics, University of Iowa, Iowa City, IA, 52242, USA
  4. Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, 30303, USA
  5. Department of Pediatrics, Women & Infants-Hospital, Brown University, Providence, RI, 02905, USA
  6. Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, 44106, USA
  7. Statistics and Epidemiology Unit, RTI International, Rockville, MD, 20852, USA
  8. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20852, USA
  9. Department of Pediatrics, Duke University, Durham, NC, 27710, USA
  
• ISSN：1432-1971

文摘

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-,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 18-2?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 18-2?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.