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Increased risk of intraventricular hemorrhage in low birth weight infants with aortic coarctation

Michael D Seckeler1, Shelby C White1, Kenneth A Fox2

  • 1Department of Pediatrics (Cardiology), University of Arizona, Tucson, AZ, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|August 29, 2018
PubMed

Insights

Low birth weight infants with aortic coarctation (CoA) have a higher risk of intraventricular hemorrhage (IVH). This association may warrant earlier intervention for CoA in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Medical Databases

Background:

  • Aortic coarctation (CoA) is a congenital heart defect.
  • Intraventricular hemorrhage (IVH) is a common complication in low birth weight (LBW) infants.
  • Early intervention for CoA in LBW infants is increasingly reported but lacks supporting data.

Purpose of the Study:

  • To investigate the association between aortic coarctation (CoA) and intraventricular hemorrhage (IVH) in low birth weight (LBW) infants.
  • To determine if this association justifies earlier intervention for CoA.

Main Methods:

  • Retrospective review of a national hospital discharge database (University Health System Consortium Clinical Data Base/Resource Manager).
  • Identification of LBW infants (≤2 kg) with and without isolated CoA and IVH.
  • Stratification of IVH by severity (low: grade 1-2, high: grade 3-4).
  • Calculation of odds ratios for IVH in infants with CoA.

Main Results:

  • A total of 46,020 LBW infants were analyzed.
  • 64 infants had CoA, with 13 (20.3%) also having IVH.
  • The odds ratio for any IVH in LBW infants with CoA was 2.91 (95% CI 1.58-5.35).
  • Odds ratios for low and high-grade IVH with CoA were 2.77 (95% CI 1.41-5.46) and 3.45 (95% CI 1.07-11.07), respectively.

Conclusions:

  • LBW infants with CoA are at a significantly increased risk of developing IVH.
  • Further research is required to assess if early catheter- or surgical-based interventions for CoA can mitigate IVH risk in this population.

Keywords:
Aortic coarctationepidemiologyintraventricular hemorrhagepremature infantssurgery

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