• Daniela Anderson, Davi Casale Aragon, Walusa A Gonçalves-Ferri, Paulo H Manso, Gabriela Leal, Krebs Vera L J VLJ Hospital das Clínicas, Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Caldas Jamil P S JPS Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, Brazil., João H C L Almeida, Manoel A S Ribeiro, Rita C Silveira, José L M B Duarte, Márcia G Penido, Daniela M L M Ferreira, José M S Alves, Karen M K Sakano, Juliana P F Santos, Carolina B Gimenes, Nathalia M M Silva, Fernanda P G Melo, Paulyne S Venzon, Jucille Meneses, Patrícia F Marques, Ligia M S S Rugolo, Daniela Testoni, and Fabio Carmona.
• Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil.
• Pediatr Crit Care Me. 2021 Jan 1; 22 (1): e99-e108.

ObjectivesTo evaluate the prevalence of congenital heart disease and their outcomes in a Brazilian cohort of very low birth weight preterm infants.DesignPost hoc analysis of data from the Brazilian Neonatal Network database, complemented by retrospective data from medical charts and a cross-sectional survey.SettingTwenty public tertiary-care university hospitals.PatientsA total of 13,955 newborns weighing from 401 to 1,499 g and between 22 and 36 weeks of gestational age, born from 2010 to 2017.InterventionsNone.Measurements And Main ResultsThe prevalence of congenital heart disease was 2.45% (95% CI, 2.20-2.72%). In a multivariate regression analysis, risk factors associated with congenital heart disease were maternal diabetes (relative risk, 1.55; 95% CI, 1.11-2.20) and maternal age above 35 years (relative risk, 2.09; 95% CI, 1.73-2.51), whereas the protection factors were maternal hypertension (relative risk, 0.54; 95% CI, 0.43-0.69), congenital infection (relative risk, 0.45; 95% CI, 0.21-0.94), and multiple gestation (relative risk, 0.73; 95% CI, 0.55-0.97). The pooled standardized mortality ratio in patients with congenital heart disease was 2.48 (95% CI, 2.22-2.80), which was significantly higher than in patients without congenital heart disease (2.08; 95% CI, 2.03-2.13). However, in multiple log-binomial regression analyses, only the presence of major congenital anomaly, gestational age (< 29 wk; relative risk, 2.32; 95% CI, 2.13-2.52), and Score for Neonatal Acute Physiology and Perinatal Extension II (> 20; relative risk, 3.76; 95% CI, 3.41-4.14) were independently associated with death, whereas the effect of congenital heart disease was spotted only when a conditional inference tree approach was used.ConclusionsThe overall prevalence of congenital heart disease in this cohort of very low birth weight infants was higher and with higher mortality than in the general population of live births. The occurrence of a major congenital anomaly, gestational age (< 29 wk), and Score for Neonatal Acute Physiology and Perinatal Extension II (> 20) were significantly and independently associated with death, whereas the association of congenital heart disease and death was only evident when a major congenital anomaly was present.Copyright © 2020 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

20 keywords...

hide…