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Congenital heart defects and preterm birth: Outcomes from a referral center
Andreia Palma1, Sofia Morais2, Patrícia V Silva1
1Department of Pediatric Cardiology, Referral Center for Congenital Cardiac Defects, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Insights
Preterm infants have more than double the risk of congenital heart defects compared to full-term infants. This study highlights a potential link between prematurity and congenital heart defects, impacting neonatal outcomes.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Public Health
Background:
- Preterm birth and congenital heart defects (CHDs) are leading causes of infant mortality.
- The precise relationship between preterm birth and CHDs remains unclear.
Purpose of the Study:
- To investigate the prevalence and types of CHDs in preterm infants.
- To determine associations between specific CHDs and preterm birth.
- To assess the impact of CHDs on outcomes in preterm neonates.
Main Methods:
- An observational, case-control study.
- Included 448 live births with CHDs (2003-2017).
- Cases: preterm neonates with CHDs; Controls: term neonates with CHDs.
Main Results:
- 23% of newborns with CHDs were preterm.
- Preterm neonates had double the odds of CHDs compared to term neonates (p<0.0001).
- Significantly higher odds of atrial (9.2-fold) and ventricular (2-fold) septal defects in preterm infants.
Conclusions:
- Preterm infants exhibit a substantially higher incidence of CHDs than term infants.
- Findings suggest a possible association between prematurity and CHDs, though etiology is uncertain.
- Neonatal mortality rates did not significantly differ between preterm and term infants with CHDs.
Background:
Preterm birth and congenital heart defects are two major causes of neonatal and infant mortality. However, the relationship between them has not yet been fully clarified.
Objective:
To determine the prevalence and spectrum of congenital heart defects in preterms, the specific associations between categories of congenital heart defects and preterm birth and to establish the influence on outcomes.
Methods:
Observational, case-control analysis that included 448 live births with congenital heart defects born between 2003 and 2017. Preterm with congenital heart defects were the case subjects and term neonates with congenital heart defects the control subjects.
Results:
Of the newborns with congenital heart defects, 23% were preterm. The odds of congenital heart defects in preterm were twofold higher than for term neonates (p<0.0001), even when considering only those with severe congenital heart defects (p=0.0002). The odds in preterm were 9.2-fold higher for abnormalities of the atria and atrial septum (p<0.0001) and two-fold higher for abnormalities of the ventricles and ventricular septum (p<0.0001) compared with term neonates. The neonatal mortality rate in the preterm group was not statistically different from that of the term group with congenital heart defects (p=0.799) or severe congenital heart defects (p=0.554).
Conclusion:
Preterm have more than twice as many congenital heart defects as term neonates. Although the etiology of prematurity between infants with congenital heart defects is still uncertain, our findings highlight a possible relationship between prematurity and congenital heart defects.
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