Congenital Anomalies in Very-Low-Birth-Weight Infants: A Nationwide Cohort Study.
Congenital malformations
Mortality
Neonatal outcome
Very low birth weight
Journal
Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
02
2020
accepted:
31
05
2020
pubmed:
11
8
2020
medline:
26
8
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
Management of newborn infants with congenital anomalies is challenging and requires a multidisciplinary approach. The prevalence of congenital anomalies in very-low-birth-weight infants (VLBWIs; birth weight <1,500 g) has been rarely reported. The aim of this study was to investigate the epidemiology of congenital anomalies in VLBWIs and the association with early mortality and major morbidities. A prospective cohort study was performed using data collected from 70 centers registered in the Korean Neonatal Network. Data from the VLBWIs with major congenital anomalies (n = 289) and the controls (n = 867), selected by 1:3 frequency matching for gestational age, were compared. The overall prevalence of major congenital anomalies in VLBWIs was 34.9 per 1,000 live births (289/8,156). The top 2 ranked subgroups of congenital anomalies were the digestive system (31.7%) and congenital heart defects (27.7%), followed by chromosomal anomalies, genitourinary tract defect, central nervous system, other anomalies, undefined, and respiratory system. The group with congenital anomalies had a higher mortality (40.7%) than the control group (11.1%). Each subgroup of congenital anomalies, except for chromosomal anomalies, increased the risk of mortality, with the highest odds ratio associated with "other" anomalies, which includes hydrops fetalis and congenital diaphragmatic hernia. In the multivariate analysis, congenital anomaly was a risk factor for mortality, bronchopulmonary dysplasia, and severe-grade intraventricular hemorrhage. VLBWIs with congenital anomaly demonstrated impaired in-hospital growth as compared with the control group. Congenital anomaly increased the risk of in-hospital mortality and was associated with short-term neonatal morbidities in the VLBWIs.
Sections du résumé
BACKGROUND
Management of newborn infants with congenital anomalies is challenging and requires a multidisciplinary approach. The prevalence of congenital anomalies in very-low-birth-weight infants (VLBWIs; birth weight <1,500 g) has been rarely reported.
OBJECTIVES
The aim of this study was to investigate the epidemiology of congenital anomalies in VLBWIs and the association with early mortality and major morbidities.
STUDY DESIGN
A prospective cohort study was performed using data collected from 70 centers registered in the Korean Neonatal Network. Data from the VLBWIs with major congenital anomalies (n = 289) and the controls (n = 867), selected by 1:3 frequency matching for gestational age, were compared.
RESULTS
The overall prevalence of major congenital anomalies in VLBWIs was 34.9 per 1,000 live births (289/8,156). The top 2 ranked subgroups of congenital anomalies were the digestive system (31.7%) and congenital heart defects (27.7%), followed by chromosomal anomalies, genitourinary tract defect, central nervous system, other anomalies, undefined, and respiratory system. The group with congenital anomalies had a higher mortality (40.7%) than the control group (11.1%). Each subgroup of congenital anomalies, except for chromosomal anomalies, increased the risk of mortality, with the highest odds ratio associated with "other" anomalies, which includes hydrops fetalis and congenital diaphragmatic hernia. In the multivariate analysis, congenital anomaly was a risk factor for mortality, bronchopulmonary dysplasia, and severe-grade intraventricular hemorrhage. VLBWIs with congenital anomaly demonstrated impaired in-hospital growth as compared with the control group.
CONCLUSION
Congenital anomaly increased the risk of in-hospital mortality and was associated with short-term neonatal morbidities in the VLBWIs.
Identifiants
pubmed: 32772029
pii: 000509117
doi: 10.1159/000509117
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
584-591Informations de copyright
© 2020 S. Karger AG, Basel.