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Clinical features of very-low-birthweight infants with congenital heart disease

Hiroko Tomotaki1,2, Katsuaki Toyoshima1, Seiichi Tomotaki1,2

  • 1Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|November 28, 2020
PubMed

Insights

Very-low-birthweight (VLBW) infants with congenital heart diseases (CHDs) requiring single-ventricular circulation surgery showed poor neurodevelopmental outcomes. Those with biventricular circulation had borderline-to-normal development, highlighting the need for further research.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Developmental Pediatrics

Background:

  • Congenital heart diseases (CHDs) in very-low-birthweight (VLBW) infants are associated with significant mortality and morbidity.
  • Limited data exists on the long-term developmental prognosis for VLBW infants with CHDs.

Purpose of the Study:

  • To investigate the mortality, morbidity, and neurodevelopmental outcomes of VLBW infants with CHDs.
  • To compare developmental quotients among different surgical intervention groups for CHDs in VLBW infants.

Main Methods:

  • Retrospective cohort study of VLBW infants (January 2006 - December 2011) admitted to a single neonatal intensive care unit.
  • Review of perinatal records for CHD diagnosis, treatment, comorbidities, mortality, and neurodevelopmental outcomes at approximately 3 years of age.
  • Comparison of neurological developmental quotients in three groups: biventricular circulation without intervention, biventricular circulation with intervention, and single-ventricular circulation.

Main Results:

  • 10.0% of 449 VLBW infants had CHDs; all 13 deaths before discharge occurred in infants with congenital abnormalities.
  • Comorbidity rates were similar between VLBW infants with and without CHDs.
  • Neurological developmental quotients were 87.2 ± 10.9 (no surgery), 91.3 ± 4.7 (intervention), and 63.7 ± 8.6 (single-ventricular circulation).

Conclusions:

  • VLBW infants with biventricular circulation CHDs demonstrated borderline-to-normal neurological development around age 3.
  • VLBW infants with single-ventricular circulation CHDs exhibited poor neurological development.
  • Further research is essential to fully understand the neurodevelopmental trajectories of VLBW infants with CHDs.
Abstract

Keywords:
Fontan procedurechromosomal abnormalitiesmortalityprognosisvery-low-birthweight infant

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