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KMID : 1130320090520040481
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Korean Journal of Pediatrics
2009 Volume.52 No. 4 p.481 ~ p.487
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Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants
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Yoo Hye-Soo
Jeong Soo-In
Chang Yun-Sil
Park Won-Soon
Lee Heung-Jae
Yang Ji-Hyuk
Jun Tae-Gook
Park Pyo-Won
Kim Ji-Eun
Kang I-Seok
Park Soo-Kyoung
Jeong Yoo-Jin
Choi Seo-Heui
Seo Hyun-Joo
Kim Sung-Hoon
Huh June
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Abstract
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Purpose: This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs).
Methods:Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065).
Results: The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (≥Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%).
Conclusions:The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.
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KEYWORD
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Infant, Very Low Birth Weight, Congenital Heart Defects, Congenital Abnormalities, Chromosome Disorders
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