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Published on: March 10, 2020
Birth outcomes of cases with conotruncal defects of heart - a population-based case-control study
Attila Vereczkey1, Zsolt Kósa, Melinda Csáky-Szunyogh
1Versys Clinics, Human Reproduction Institute , Budapest , Hungary .
Insights
Conotruncal defects (CTDs) are linked to lower birth weight and intrauterine growth restriction, especially in female infants. Common truncus is an exception, affecting gestational age and birth weight differently.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Neonatology
Background:
- Congenital heart defects are a significant concern in newborns.
- Conotruncal defects (CTDs) represent a group of severe congenital heart anomalies.
- Understanding the impact of CTDs on birth outcomes is crucial for clinical management.
Purpose of the Study:
- To evaluate and compare birth outcomes in infants with four specific conotruncal defects (CTDs).
- The CTDs studied include common truncus, transposition of great arteries, tetralogy of Fallot, and double-outlet right ventricle.
Main Methods:
- A population-based dataset from the Hungarian Case-Control Surveillance of Congenital Abnormalities was utilized.
- Birth outcomes of 597 live-born cases with CTD were compared to 38,151 population controls.
- Socio-demographic data of mothers were also incorporated into the analysis.
Main Results:
- Infants with CTDs showed a male predominance (56.8%) but similar gestational age and preterm birth rates compared to controls.
- A significantly higher rate of low birth weight (14.6% vs. 5.7%) and smaller mean birth weight (3077g vs. 3276g) were observed in CTD cases.
- Intrauterine growth restriction was noted in transposition of great arteries, tetralogy of Fallot, and double-outlet right ventricle, particularly in females. Common truncus cases had shorter gestational age and lower birth weight.
Conclusions:
- Most CTDs, excluding common truncus, do not significantly affect gestational age but are associated with a high risk of intrauterine fetal growth restriction.
- This growth restriction is particularly pronounced in female infants diagnosed with these heart defects.
- Common truncus presents a distinct pattern of altered birth outcomes compared to other CTDs studied.
Objective:
The aim of this study was to evaluate the birth outcomes of cases with four types of conotruncal defects (CTDs), i.e. common truncus, transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle.
Methods:
Birth outcomes of 597 live-born cases with CTD and 38,151 population controls without any defects were compared in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities completed by socio-demographic variables of their mothers.
Results:
There was a male excess in cases with CTD (56.8%) with the same mean gestational age (39.4 versus 39.4 weeks) and preterm birth rate (8.2 versus 9.2%), but their mean birth weight was smaller (3077 versus 3276 g) with a high rate of low birthweight (14.6 versus 5.7%) compared to the birth outcomes of population controls. These data indicate intrauterine growth restriction of fetuses affected with transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle particularly in females, while there were a shorter mean gestational age and smaller mean birth weigh in cases with common truncus.
Conclusions:
In general CTD, except common truncus, had no effect for gestational age but associated with a high risk for intrauterine fetal growth restriction particularly in female cases.
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