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Prevalence of Critical Congenital Heart Defects Among Neonates Born With Abdominal Wall Defects
Zane J Hellmann1, Linh Buu1, Shahyan Rehman1
1Yale New Haven Children's Hospital, New Haven, Connecticut, USA.
Insights
Infants with gastroschisis have a significantly higher risk of critical congenital heart defects (CCHD). This combination leads to increased rates of cardiac surgery and mortality during neonatal intensive care unit (NICU) admissions.
Area of Science:
- Neonatalogy
- Pediatric Cardiology
- Congenital Anomalies
Background:
- Gastroschisis is a major congenital anomaly with significant impact on neonatal outcomes.
- The co-occurrence of critical congenital heart defects (CCHD) in infants with gastroschisis is not well-established.
- This study investigates the prevalence and impact of CCHD in neonates with gastroschisis.
Purpose of the Study:
- To determine the prevalence of CCHD in infants born with gastroschisis.
- To assess the outcomes of neonates with both gastroschisis and CCHD during their neonatal intensive care unit (NICU) admission.
Main Methods:
- Utilized US Department of Health and Human Services data for live birth rates of gastroschisis, omphalocele, and CCHD.
- Analyzed Pediatric Health Information System (PHIS) data from 2017-2023 for NICU admissions involving gastroschisis, omphalocele, or CCHD using ICD-10 codes.
Main Results:
- Infants with gastroschisis showed a significantly higher prevalence of CCHD (OR = 8.18).
- Neonates with both gastroschisis and CCHD experienced increased rates of open cardiac surgery (OR = 12.20) and mortality (OR = 9.56) during NICU admission.
Conclusions:
- Infants with gastroschisis have a substantially higher likelihood of being diagnosed with CCHD.
- The combined diagnosis of gastroschisis and CCHD is associated with poorer outcomes, including higher rates of cardiac surgery and mortality in the NICU.
Introduction:
We hypothesized that there is a higher prevalence of critical congenital heart defects (CCHD) among infants born with gastroschisis, which leads to worse outcomes during index neonatal intensive care unit (NICU) admission.
Methods:
Rates of gastroschisis, omphalocele, and CCHD were calculated from Department of Health and Human Services (HHS) annual data on all live births in the US. Separately, NICU admissions to the Pediatric Health Information System (PHIS) between 2017 and 2023 were analyzed for diagnosis of gastroschisis, omphalocele, or CCHD, as identified by ICD-10 codes.
Results:
Neonates diagnosed with gastroschisis carried a concomitant diagnosis of CCHD more frequently than the general population (OR = 8.18, 95% CI 5.56-12.02). Among NICU admissions to PHIS hospitals, neonates diagnosed with both gastroschisis and CCHD had higher rates of open cardiac surgery (OR = 12.20, 95% CI 2.36-63.08, p < 0.001) and mortality (OR = 9.56, 95% CI 1.72-53.07, p = 0.004) during index admission compared to the general NICU population.
Discussion:
The current study demonstrates that infants born with gastroschisis are more likely to be diagnosed with CCHD than the general population. A diagnosis of both gastroschisis and CCHD resulted in higher rates of open cardiac surgery and mortality during index hospital admission.
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