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Retrospective evaluation of mortality due to congenital heart disease in the neonatal intensive care unit
Azize Büyükkoç1, Yusuf Izzet Ayhan2, Nurdan Erol3, Ilke Mungan Akın4, Derya Büyükkayhan51Division of Developmental Behavior, Department of Pediatrics, University of Health Sciences, Turkey. Istanbul Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Istanbul, Turkey2Division of Pediatric Cardiology, Department of Pediatrics, Bezmialem Vakif University, Dragos Hospital, Istanbul, Turkey
3Division of Pediatric Cardiology, Department of Pediatrics, University of Health Sciences, Turkey. Istanbul Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Istanbul, Turkey
4Division of Neonatal Intensive Care, Department of Neonatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
5Division of Neonatal Intensive Care, Department of Neonatology, University of Health Sciences, Haseki Research and Education Hospital, Istanbul, Turkey
INTRODUCTION: Congenital heart disease (CHD) is one of the most common congenital anomalies and a leading cause of neonatal morbidity and mortality. Early identification of risk factors associated with mortality in affected newborns is essential for improving outcomes. This study aimed to determine the prevalence, mortality rate, and independent risk factors associated with mortality among newborns with CHD admitted to the neonatal intensive care unit (NICU).
METHODS: This retrospective study examined newborns with CHD followed up in the NICU of Medeniyet University, Göztepe Training and Research Hospital between January 2010 and January 2014. Sociodemographic, perinatal, and clinical data were extracted from a detailed review of medical records.
RESULTS: The prevalence of CHD was 6.5% in 3023 neonates followed up in the NICU. The most common CHD types were PDA (21.3%), PFO (15.7%), and VSD (14.2%). The mortality rate in newborns with CHD was 13.2% (n=26). Factors independently associated with mortality in these newborns included a low first-minute Apgar score (OR: 0.777, p=0.039), hypoplastic left heart syndrome (OR: 19.397, p=0.005), cardiomyopathy (OR: 7.607, p=0.042), and the need for endotracheal intubation (OR: 9.731, p=0.005).
DISCUSSION AND CONCLUSION: The prevalence of CHD diagnosis in our NICU setting was 6.5%, and the mortality rate in these newborns was 13.2%. Neonates with low Apgar scores, hypoplastic left heart syndrome, cardiomyopathy, and those undergoing endotracheal intubation should be monitored closely to allow for prompt life-saving interventions. Larger population-based studies are warranted to improve perinatal and postnatal management strategies for CHD.
Keywords: Cardiomyopathy, congenital heart defects, infant, newborn, mortality, neonatal intensive care units, risk factors.
Manuscript Language: English
