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Relationship of birth weight with congenital cardiovascular malformations in a population-based study
Robert A Petrossian1, Karen S Kuehl2, Christopher A Loffredo1
11Lombardi Comprehensive Cancer Center,Georgetown University,Washington,District of Columbia,United States of America.
Insights
Congenital cardiovascular malformations are linked to lower birth weights, with specific defects causing greater deficits. These birth weight reductions are not solely due to prematurity, indicating other underlying mechanisms.
Area of Science:
- Pediatric Cardiology
- Neonatal Health
- Developmental Biology
Background:
- Low birth weight is a known comorbidity of congenital cardiovascular malformations (CCMs).
- The underlying reasons for the association between CCMs and low birth weight remain unclear.
- This study investigates the relationship between specific CCM types and birth weight, controlling for gestational age.
Purpose of the Study:
- To examine the association between various types of congenital cardiovascular malformations and birth weight in singletons.
- To determine if prematurity accounts for the observed birth weight differences in infants with CCMs.
- To identify specific CCMs associated with significant birth weight deficits.
Main Methods:
- Retrospective analysis of the population-based Baltimore-Washington Infant Study.
- Inclusion of 3519 control infants and specific CCM groups: d-transposition of the great arteries, conotruncal defects, endocardial cushion defects, left heart obstructive lesions, atrial septal defects, and membranous ventricular septal defects.
- Linear regression analysis adjusting for gestational age and other covariates.
Main Results:
- Significant birth weight deficits were observed for infants with conotruncal heart defects (-218 g), endocardial cushion defects with Down syndrome (-265 g), endocardial cushion defects without Down syndrome (-194 g), left heart obstructive lesions (-143 g), atrial septal defects (-150 g), and membranous ventricular septal defects (-127 g).
- Infants with d-transposition of the great arteries showed no significant birth weight deficit (-67 g).
- The magnitude of birth weight reduction varied significantly depending on the specific type of CCM.
Conclusions:
- The specific type of congenital cardiovascular malformation is strongly correlated with the degree of birth weight deficit.
- The observed low birth weights in infants with CCMs are not solely attributable to prematurity.
- Additional mechanisms beyond prematurity are implicated in the association between CCMs and reduced birth weight.
Introduction:
A known comorbidity of congenital cardiovascular malformations is low birth weight, but the reasons for this association remain obscure. This retrospective study examines the relationship between congenital cardiovascular malformations and the birth weight of singletons, taking into account differences in gestational age and other factors.
Methods:
Using data from the retrospective, population-based Baltimore-Washington Infant Study, six types of congenital cardiovascular malformations were investigated in comparison with controls (n=3519) through linear regression: d-transposition of the great arteries (n=187), other conotruncal heart defects (n=361), endocardial cushion defects (n=281), left heart obstructive lesions (n=507), atrial septal defects (n=281), and membranous ventricular septal defects (n=622).
Results:
Infants with conotruncal heart defects (-218 g), endocardial cushion defects with Down syndrome (-265 g), endocardial cushion defects without Down syndrome (-194 g), left heart obstructive lesions (-143 g), atrial septal defects (-150 g), and membranous ventricular septal defects (-127 g) showed significant birth weight deficits, adjusting for gestational age, and other covariates. Infants with d-transposition of the great arteries (-67 g) did not show significant birth weight deficits compared with the control group.
Discussion:
The degree of birth weight decrement appears to be highly related to the specific type of congenital cardiovascular malformation. As a whole, these infants do not exhibit low birth weights solely because of being premature, and thus other mechanisms must underlie these associations.
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