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Mortality and Morbidity in Preterm Infants with Congenital Heart Disease


Acta Paediatr. 2021 Oct 16. doi: 10.1111/apa.16155. Online ahead of print.

ABSTRACT

AIM: To compare in-hospital mortality and rates of necrotising enterocolitis (NEC), sepsis, IVH and length of invasive respiratory support in preterm infants <36 weeks’ gestation with congenital heart disease (CHD) to matched preterm infants without CHD in a single London centre over 13-year period.

METHODS: Single-centre retrospective case-control study over the 13-year period from May 2004 to May 2017.

RESULTS: 247 preterm infants with CHD were matched to 494 infants without CHD. Patients with CHD had a significantly increased risk of in-hospital mortality compared to controls (OR 7.39 (95% CI 4.37-12.5); P<0.001). Preterm infants with CHD had a higher risk of NEC (OR 2.42 (95% CI 1.32-4.45); P=0.005), sepsis (OR 1.68 (95% CI 1.23-2.28); P=0.001) and invasive respiratory support ≥28 days (OR 2.34 (95% CI 1.19-4.58); P=0.017). Risk of IVH was lower in preterm infants with CHD (OR 0.22 (95% CI 0.11-0.42); P=0.0001).

CONCLUSION: Preterm birth with CHD is associated with a higher risk of in-hospital mortality, NEC, sepsis and prolonged invasive respiratory support, but a lower risk of IVH compared to matched controls. In-hospital mortality remains high in moderate to late preterm infants with CHD.

PMID:34655490 | DOI:10.1111/apa.16155

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