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Birthweight and isolated congenital heart defects - A systematic review and meta-analysis

Moska Aliasi1, Maartje C Snoep1, Nan van Geloven2

  • 1Department of Obstetrics and Fetal Medicine, Leiden University Medical Centre, Leiden, The Netherlands.

BJOG : an International Journal of Obstetrics and Gynaecology
|March 30, 2022
PubMed

Insights

Infants with congenital heart defects (CHD) show impaired birthweight (BW) with increased risk of being small-for-gestational age (SGA). Standardized BW z-scores are crucial for assessing growth in fetuses with CHD.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Fetal Development

Background:

  • Birthweight (BW) is a critical prognostic indicator for newborns diagnosed with congenital heart defects (CHD).
  • Understanding BW variations in infants with CHD is essential for clinical management and research.
  • Previous studies suggest a potential link between CHD and altered fetal growth patterns.

Purpose of the Study:

  • To systematically review and synthesize existing literature on birthweight z-scores in neonates with isolated congenital heart defects.
  • To provide a comprehensive overview of the prevalence and implications of BW z-scores and small-for-gestational age (SGA) in this population.
  • To identify trends and associations between CHD and fetal growth parameters.

Main Methods:

  • A systematic literature search was conducted across major databases including PubMed, Embase, Web of Science, COCHRANE Library, and Emcare.
  • Studies focusing on isolated CHD and reporting BW percentiles, BW z-scores, or % SGA were included.
  • Meta-analysis was employed to pool BW z-scores and SGA prevalence, with quality assessed using the modified Newcastle Ottawa Scale.

Main Results:

  • Twenty-three articles encompassing 27,893 cases were included in the analysis.
  • The pooled BW z-score for infants with isolated CHD was -0.20, indicating a slight but significant reduction from the norm.
  • The overall prevalence of SGA (below the 10th percentile) was 16.0%, with similar findings in subgroup analyses of major CHD.

Conclusions:

  • Infants with isolated CHD exhibit impaired birthweight, characterized by lower BW z-scores and a 1.6-fold increased risk of SGA, regardless of CHD type.
  • These findings highlight the intrinsic association between congenital heart defects and fetal growth.
  • The study advocates for the consistent use of standardized BW z-scores and international growth charts in CHD research to better understand fetal development.
Abstract

Keywords:
birthweightcongenital heart defectsfetal growthintrauterine growthmeta-analysissmall for gestational agesystematic review

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