Skip to main content Skip to main navigation menu Skip to site footer

Predictors of neonatal mortality with congenital heart disease

  • Made Indah Pradnya Paramita ,
  • Eka Gunawijaya ,
  • Ni Putu Veny Kartika Yantie ,
  • Made Kardana ,


Abstract

Link of Video Abstract : https://youtu.be/Vi3785NsB1A

 

Introduction: Congenital heart disease (CHD) is the leading cause of birth defect-associated infant illness and death. In developing countries, the mortality related to CHD increased by up to 25%, but the data about predictors of mortality are limited. The purpose of this study was to investigate the predictors of mortality in neonates with CHD.

Methods: We conducted a case-control study of neonatal mortality with CHD from January 2018 to October 2022. Data were collected from the neonatal registry in Prof Ngoerah Hospital, Bali. Characteristics and clinical risk of mortality were analyzed. Chi-square and logistic regression analysis was carried out to determine the potential predictor of mortality. 

Results: A total of 288 neonatal with CHD were analyzed. Neonatal morbidities such as extremely low birth weight (ELBW) were found in 7.6%, asphyxia in 50.7%, multiple congenital anomalies (MCA) in 13.2%, pulmonary hypertension (PH) in 13.5%, sepsis in 66.3%, and severe form of CHD in 50.7%. Patent ductus arteriosus (PDA) was the most acyanotic CHD (35%). Mortality resulting from CHD was 27%. ELBW, severe and moderate asphyxia, MCA, PH, sepsis, and severe form of CHD were significant mortality predictors (p<0.05) with (OR; 95%CI) were (6.21; 1.24-31.12), (4.13; 1.93-8.81), (3.20;1.69-6.08), (2.70; 1.17-6.24), (2.54;1.10-5.84), (2.33; 1.28-4.22), (2.00; 1.15-3.49) respectively.

Conclusion: ELBW, severe and moderate asphyxia, MCA, PH, sepsis, and severe forms of CHD are predictors of neonatal mortality with CHD.

Keywords: congenital heart disease mortality neonates predictors

References

  1. Mat Bah MN, Sapian MH, Jamil MT, et al. Survival and Associated Predictors for Mortality Among Infants with Critical Congenital Heart Disease in a Developing Country. Pediatr Cardiol. 2018;39(7):1389-96.
  2. Wu W, He J, Shao X. Incidence and mortality trend of congenital heart disease at the global, regional, and national level, 1990–2017. Medicine.2020;99(23):e20593.
  3. Talargia F, Seyoum G, Moges T. Congenital Heart Defects and Associated Factors in Children with Congenital Anomalies. Ethiop Med J. 2018;56(4):335–42.
  4. Abqari S, Gupta A, Shahab T, et al. Profile and predictors for congenital heart defects: A study in a tertiary care hospital. Ann Pediatr Cardiol. 2016;9(3):216-21.
  5. Willim HA, Cristianto, Supit AI. Critical Congenital Heart Disease in Newborn: Early Detection, Diagnosis, and Management. Bioscmed. 2020;5:107-16.
  6. Gilboa SM, Salemi JL, Nembhard WN, et al. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006. Circulation. 2010;122(22):2254-63.
  7. Gomella TL. Gestational Age and Birthweight Classification. In: Gomella TL, Cunningham MD, Eyal FG, Zenk KE, editors. Neonatology: management, procedures, on-call problems, disease, and drugs. 8th ed. London: Appleton & Lange; 2020:42.
  8. Olney RS, Ailes EC, Sontag MK. Detection of critical congenital heart defects: Review of prenatal and newborn screening contributions. Semin Perinatol. 2015;39(3):230-7.
  9. Murni IK, Wirawan MT, Patmasari L, et al. Delayed diagnosis in children with congenital heart disease: a mixed-method study. BMC Pediatr. 2021;21(1):191.
  10. Krishna MR, Kumar RK. Diagnosis and Management of Critical Congenital Heart Diseases in the Newborn. Indian J Pediatr. 2020;87(5):365-71.
  11. Rohsiswatmo R, Rundjan L. Resusitasi Neonatus. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2014.
  12. Rocha LA, Froio SC, Silva CC, et al. Predictors for Mortality in Children with Congenital Heart Disease Delivered at a Brazilian Tertiary Center. Braz J Cardiovasc Surg. 2018;33(6):603-607.
  13. Nasr VG, Staffa SJ, Faraoni D, et al. Trends in mortality rate in patients with congenital heart disease undergoing noncardiac surgical procedures at children's hospitals. Sci Rep. 2021;11(1):1543.
  14. Connelly MS, et al. Canadian Consensus Conference on Adult Congenital Heart Disease, 1996. Can J Cardiol 1998;14:395–452.
  15. Giraldo-Grueso M, Zarante I, Mejía-Grueso A, et al. Predictors for congenital heart disease: A case-control study. Revista Colombiana de Cardiología. 2020;27(4):324-9.
  16. Gomella TL, Eyal FG, Mohammed FB. Medications Used in the Neonatal Intensive Care Unit. Dalam: Gomella TL, Eyal FG, Mohammed FB, penyunting. Neonatology: management, procedures, on-call problems, diseases, drugs. Eight Edition. New York: Lange Medical Book/McGraw-Hill; 2020. h. 1225–315.
  17. Lopes SAVDA, Guimarães ICB, Costa SFO, et al. Mortality for Critical Congenital Heart Diseases and Associated Predictors in Newborns. A Cohort Study. Arq Bras Cardiol. 2018;111(5):666-73.
  18. Gomella TL, Eyal FG, Mohammed FB. Sepsis. Dalam: Gomella TL, Eyal FG, Mohammed FB, editors. Neonatology: management, procedures, on-call problems, diseases, drugs. Eight Edition. New York: Lange Medical Book/McGraw-Hill; 2020. pp. 1175–88.
  19. Pascall E, Tulloh RM. Pulmonary hypertension in congenital heart disease. Future Cardiol. 2018;14(4):343-53
  20. Eckersley L, Sadler L, Parry E, et al. Timing of diagnosis affects mortality in critical congenital heart disease. Arch Dis Child. 2016;101(6):516-20.
  21. Massin MM, Dessy H. Delayed recognition of congenital heart disease. Postgrad Med J. 2006;82(969):468-70.
  22. Landis BJ, Levey A, Levasseur SM, et al. Prenatal diagnosis of congenital heart disease and birth outcomes. Pediatr Cardiol. 2013;34(3):597-605.
  23. Peake LK, Draper ES, Budd JL, et al. Outcomes when congenital heart disease is diagnosed antenatally versus postnatally in the UK: a retrospective population-based study. BMC Pediatr. 2015;15:58.
  24. Rashid U, Qureshi AU, Hyder SN, et al. The pattern of congenital heart disease in a developing country tertiary care center: Factors associated with delayed diagnosis. Ann Pediatr Cardiol. 2016;9(3):210-5.
  25. Cheng HH, Almodovar MC, Laussen PC, et al. Outcomes and predictors for mortality in premature neonates with critical congenital heart disease. Pediatr Cardiol. 2011;32(8):1139-46.
  26. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med. 2001;344(7):467-71.
  27. Hunter S, Heads A, Wyllie J, et al. Prenatal diagnosis of congenital heart disease in northern England: benefits of a training program for obstetric ultrasonographers. Heart. 2000;84(3):294-8.
  28. Wren C, Richmond S, Donaldson L. Temporal variability in birth prevalence of cardiovascular malformations. Heart. 2000;83(4):414-9.
  29. Mat Bah MN, Tan RYH, Razak H, et al. Survival and associated predictors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia. J Perinatol. 2021;41(4):786-93.
  30. Calzolari E, Barisic I, Loane M, et al. Epidemiology of multiple congenital anomalies in Europe: a EUROCAT population-based registry study. Birth Defects Res A Clin Mol Teratol. 2014;100(4):270-6.
  31. Obrigado A. Early Diagnosis of Congenital Heart Disease in the Neonatal Period. In: Dey S, editor. Prenatal Diagnosis and Screening for Down Syndrome. Shanghai: InTech; 2011. 149–64.
  32. Hidayati IS, Murni IK, Wandita S. Skor Prediksi Kematian Neonatus dengan Penyakit Jantung Bawaan Kritis (thesis). Jogjakarta: Gadjah Mada University. 2019.
  33. Van der Feen DE, Bartelds B, de Boer RA, et al. Pulmonary arterial hypertension in congenital heart disease: translational opportunities to study the reversibility of pulmonary vascular disease. Eur Heart J. 2017;38(26):2034-41.
  34. Kozlik-Feldmann R, Hansmann G, Bonnet D, et al. Pulmonary hypertension in children with congenital heart disease (PAH-CHD, PPHVD-CHD). Expert consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart. 2016;102(2):42-8.
  35. D'Alto M, Mahadevan VS. Pulmonary arterial hypertension associated with congenital heart disease. Eur Respir Rev. 2012;21(126):328-37.

How to Cite

Pradnya Paramita, M. I., Gunawijaya, E. ., Yantie, N. P. V. K. ., & Kardana, M. . (2023). Predictors of neonatal mortality with congenital heart disease. Bali Medical Journal, 12(1), 1114–1119. https://doi.org/10.15562/bmj.v12i1.4218
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
5

Total
0

Share

Search Panel

Made Indah Pradnya Paramita
Google Scholar
Pubmed
BMJ Journal

Eka Gunawijaya
Google Scholar
Pubmed
BMJ Journal

Ni Putu Veny Kartika Yantie
Google Scholar
Pubmed
BMJ Journal

Made Kardana
Google Scholar
Pubmed
BMJ Journal