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Outcomes of congenital heart disease in late preterm infants: double jeopardy?

Girija Natarajan1, Sreedhar R Anne, Sanjeev Aggarwal

  • 1Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, MI 48201, USA.

Acta Paediatrica (Oslo, Norway : 1992)
|March 3, 2011
PubMed

Insights

Late preterm infants with congenital heart defects face higher risks for complications and death compared to term infants. These findings emphasize the vulnerability of premature infants with heart conditions requiring surgery.

Area of Science:

  • Neonatal surgery
  • Pediatric cardiology
  • Perinatology

Background:

  • Congenital heart defects (CHDs) are a significant concern in neonates.
  • Late preterm infants (34-36 6/7 weeks gestation) may have different outcomes compared to term infants when CHDs require surgical intervention.

Purpose of the Study:

  • To compare surgical outcomes in late preterm infants with CHDs versus term infants with CHDs.
  • To identify specific vulnerabilities and complications in late preterm infants undergoing cardiac surgery.

Main Methods:

  • Retrospective chart review of consecutive late preterm and term infants with CHDs.
  • Infants included required surgical intervention during their initial hospital admission.
  • Comparison of outcomes between late preterm (n=26) and term (n=62) infant groups.

Main Results:

  • Late preterm infants had significantly earlier gestation, lower birth weight, and were older at the time of surgery.
  • Higher rates of prostaglandin E1 (PGE1) infusion, preoperative pressor use, and mortality were observed in the late preterm group.
  • Late preterm infants experienced significantly higher rates of necrotizing enterocolitis, seizures, oxygen dependency, and gavage feeding at discharge.

Conclusions:

  • Late preterm infants with CHDs requiring surgery are extremely vulnerable.
  • The combination of prematurity and congenital heart defects significantly increases the risk of adverse outcomes.
  • These findings underscore the need for specialized care and monitoring for this high-risk population.
Abstract

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