Faculty Collaboration Database

Effect of Fetal Growth on 1-Year Mortality in Neonates With Critical Congenital Heart Disease. J Am Heart Assoc 2018 Sep 04;7(17):e009693

Date

10/30/2018

Pubmed ID

30371167

Pubmed Central ID

PMC6201429

DOI

10.1161/JAHA.118.009693

Scopus ID

2-s2.0-85054540521 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

Background Infants with critical congenital heart disease ( CCHD ) are more likely to be small for gestational age (GA). It is unclear how this affects mortality. The authors investigated the effect of birth weight Z score on 1-year mortality separately in preterm (GA <37 weeks), early-term (GA 37-38 weeks), and full-term (GA 39-42 weeks) infants with CCHD . Methods and Results Live-born infants with CCHD and GA 22 to 42 weeks born in California 2007-2012 were included in the analysis. The primary predictor was Z score for birth weight and the primary outcome was 1-year mortality. Multivariable logistic regression was used. Results are presented as adjusted odds ratios and 95% confidence intervals ( CIs ). The authors identified 6903 infants with CCHD . For preterm and full-term infants, only a Z score for birth weight <-2 was associated with increased mortality compared with the reference group ( Z score 0-0.5, adjusted odds ratio, 2.15 [95% CI , 1.1-4.21] and adjusted odds ratio, 3.93 [95% CI , 2.32-6.68], respectively). In contrast, in early-term infants, the adjusted odds ratios for Z scores <-2, -2 to -1, and -1 to -0.5 were 3.42 (95% CI , 1.93-6.04), 1.78 (95% CI , 1.12-2.83), and 2.03 (95% CI , 1.27-3.23), respectively, versus the reference group. Conclusions GA seems to modify the effect of birth weight Z score on mortality in infants with CCHD . In preterm and full-term infants, only the most severe small-for-GA infants ( Z score <-2) were at increased risk for mortality, while, in early-term infants, the risk extended to mild to moderate small-for-GA infants ( Z score <-0.5). This information helps to identify high-risk infants and is useful for surgical planning.

Author List

Steurer MA, Baer RJ, Burke E, Peyvandi S, Oltman S, Chambers CD, Norton ME, Rand L, Rajagopal S, Ryckman KK, Feuer SK, Liang L, Paynter RA, McCarthy M, Moon-Grady AJ, Keller RL, Jelliffe-Pawlowski LL

Author

Liang Liang PhD Assistant Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Birth Weight
Comorbidity
Female
Fetal Development
Fetal Growth Retardation
Fetal Macrosomia
Gestational Age
Heart Defects, Congenital
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Logistic Models
Male
Mortality
Multivariate Analysis
Odds Ratio
Severity of Illness Index