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Hydrops fetalis-trends in associated diagnoses and mortality from 1997-2018
Veeral N Tolia1,2,3, R Hunter Clark4, Bezalel Perelmuter5
1The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL, USA. Veeral.tolia@bswhealth.org.
Objectives:
To describe and evaluate trends in the etiology and mortality risk in neonates admitted for neonatal intensive care with hydrops fetalis.
Study Design:
A retrospective review of de-identified patient data in the Pediatrix Clinical Data Warehouse from 1997 to 2018.
Results:
We identified 2144 infants diagnosed with hydrops fetalis. The most common diagnoses were congenital heart disease (n = 325, 15.2%), genetic diagnoses (n = 269, 12.5%) and cardiac arrhythmia (n = 176, 8.2%). Of 2144 neonates, 988 (46%) survived to hospital discharge and 775 (36%) died prior to discharge. Mortality rate was highly variable across diagnoses, ranging from 90% in infants with congenital diaphragmatic hernia to 0% in infants with atrial flutter. Over the study period, more infants were diagnosed with trisomies and fewer with twin-to-twin transfusion. Mortality decreased by 5% from 1997-2007 to 2008-2018.
Conclusions:
The risk of death among neonates with hydrops fetalis is highly dependent on the underlying cause, with increasing risk of mortality at lower gestational ages.
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