Left ventricular dysfunction in the immediate post-natal period.

Area of Science:

• Neonatology
• Pediatric Cardiology
• Perinatal Medicine

Background:

• Left ventricle (LV) dysfunction in newborns can arise from maladaptation to extrauterine life.
• This study investigates newborns with LV dysfunction in the first 48 hours of life, excluding perinatal asphyxia and structural heart disease.

Purpose of the Study:

• To examine the clinical presentation, echocardiographic findings, and outcomes of neonatal LV dysfunction.
• To explore the hypothesis that LV dysfunction results from maladaptation to extrauterine life.

Main Methods:

• Retrospective cohort analysis of late preterm and term neonates diagnosed with LV dysfunction within 48 hours of birth.
• LV dysfunction defined by echocardiographic parameters (FS <28% or EF <50%) or cardiologist assessment.
• Data included demographics, echocardiograms, clinical status, and medications; primary outcome was time to LV function recovery.

Main Results:

• 19 neonates were analyzed; mean gestational age was 38 weeks.
• No identifiable cause was found in 68% of infants; 21% had maternal illicit drug exposure.
• Three infants died; all infants without identifiable etiologies recovered LV function within 14 days.

Conclusions:

• Neonatal left ventricle (LV) dysfunction can occur during the transition from fetal to neonatal circulation.
• Maternal illicit drug use is a potential associated factor.
• Most cases of unexplained LV dysfunction resolve spontaneously within two weeks.