Birth Weight and Cardiovascular Malformations: A Population-Based Study

Rosenthal, Geoffrey L.; Wilson, P. David; Permutt, Thomas; Boughman, Joann A.; Ferencz, Charlotte

doi:10.1093/oxfordjournals.aje.a115839

Cited by 128 publications

(94 citation statements)

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“…In particular, there are higher incidence rates of coarctation of the aorta, doubleinlet left ventricle, hypoplastic left heart, truncus arteriosus, double-outlet right ventricle (a diagnostic category we did not use), and atrioventricular septal defect among stillbirths. Interestingly, this spectrum of malformations is similar to that shown in Fig 2 and those reported by Rosenthal et al 31 and Kramer et al, 32 as discussed above. Whether the increased prevalence of cardiovascular malformations among preterm infants and the increase in stillbirths reported by Hoffman 34 suggest clues to the cause is difficult to say.…”

Section: E836supporting

confidence: 90%

“…21 Although birth weight was recorded for all cases in our register, our analysis was on the basis of gestational age alone. Rosenthal et al 31 reported a case-control study of birth weight in relation to estimated gestational age among singleton infants with a limited range of isolated cardiovascular malformations. They found a significant increase in the likelihood of being small for gestational age among infants with tetralogy of Fallot, complete atrioventricular septal defect, hypoplastic left heart, or large ventricular septal defect.…”

Section: E836mentioning

confidence: 99%

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Cardiovascular Malformations Among Preterm Infants

2005

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ABSTRACT. Objective. Preterm birth and cardiovascular malformations are the 2 most common causes of neonatal and infant death, but there are no published population-based reports on the relationship between them. We undertook this study to determine the prevalence and spectrum of cardiovascular malformations in a preterm population, the prevalence of prematurity among infants with cardiovascular malformations, and the influence of prematurity and cardiovascular malformations on outcomes.Methods. We based the study on the population of the former Northern Health Region of England. We identified all live-born infants with cardiovascular malformations diagnosed in the first 1 year of life from the regional pediatric cardiology database, which includes the gestational age and details of the diagnosis. We limited ascertainment to malformations diagnosed by the age of 12 months. Infants with isolated patent ductus arteriosus or atrial septal defect were excluded, to avoid ascertainment bias. Infants with ventricular septal defect were classified according to whether they required surgery in the first 1 year. There are no population data on gestational ages for all births in our population for the era of this study; therefore, we used data published in the literature for populations similar to our own to predict that 0.4% of live births occur at <28 weeks of gestation, 0.9% at 28 to 31 weeks, and 6% at 32 to 36 weeks. Overall, 7.3% of live-born infants are preterm.Results. Of 521 619 live-born infants in 1987-2001, 2964 had cardiovascular malformations (prevalence: 5.7 cases per 1000 live births). Cardiovascular malformations were present at 5.1 cases per 1000 term infants and 12.5 cases per 1000 preterm infants. The odds ratio (OR) for a cardiovascular malformation in prematurity was 2.4 (95% confidence interval [CI]: 2.2-2.7). We found that 474 infants (16%) with cardiovascular malformations were born at <37 weeks of gestation, giving an OR for prematurity among infants with a cardiovascular malformation of 2.4 (95% CI: 2.2-2.7). More infants were born preterm with diagnoses of pulmonary atresia with ventricular septal defect (23%), complete atrioventricular septal defect (22%), and coarctation of the aorta, tetralogy of Fallot, and pulmonary valve stenosis (each 20%). Fewer were born preterm with diagnoses of pulmonary atresia and intact ventricular septum (7%), transposition of the great arteries (8%), and single ventricle (9%). We found that 18% of infants with ventricular septal defect requiring surgery were preterm, compared with 13% in the nonsurgical group. Preterm infants with ventricular septal defect required surgery in 30% of cases, compared with 23% of term infants with ventricular septal defect. These figures show that the excess of cardiovascular malformations among preterm infants cannot be explained by greater ascertainment of minor ventricular septal defects. In our denominator population, 646 live-born infants were recognized as having trisomy 21, and gestational age data were available for 609. Of ...

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confidence: 90%

Section: E836mentioning

confidence: 99%

Cardiovascular Malformations Among Preterm Infants

2005

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“…Pela análise univariada, foi observada associação entre presença de cardiopatia congênita e peso ao nascimento ≤ 2.500 g, o que também é descrito na literatura [29][30][31] …”

Section: Objetivosunclassified

Presentation of congenital heart disease diagnosed at birth: analysis of 29,770 newborn infants

Amorim¹,

Pires²,

Lana³

et al. 2008

J Pediatr (Rio J)

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Methods:A retrospective, database driven study, part of the LatinAmerican collaborative study of congenital malformations. Records were reviewed on all live born (LB) and stillborn (SB) infants with congenital heart diseases diagnosed by postnatal echocardiogram or by autopsy. Data on birth weight, sex, age and parity were collected for the LB and studied for associations. The statistical analysis employed Pearson's chisquare test and multinomial logistic regression.Results: During the period studied there were 29,770 births (28,915 LB and 855 SB). The prevalence of heart disease among the LB was 9.58:1,000 (277/28,915) while among SB the rate was 87.72:1,000 (75/ 855). Heart disease occurred isolated in 37.2% of LB cases and 18.7% of SB cases; was associated with anomalies of other organs and systems, but without a syndromic diagnosis in 31.4% of LB cases and 48.0% of SB cases; and in 23.1% of the LB cases and 32.0% of the SB cases the heart disease was a feature of a syndrome. Multivariate analysis demonstrated an association between heart disease and birth weight ≤ 2,500 g in all types of clinical presentation, between maternal age ≥ 35 years and heart disease in syndromic heart disease and between female sex and isolated heart disease. Conclusions:It was found a high prevalence, which is an alert to the medical significance of heart disease. There was association between birth weight ≤ 2,500 g and all forms of presentation, between increased maternal age and syndromic heart disease besides between female sex and isolated congenital heart disease. J Pediatr (Rio J). 2008;84(1):83-90:Congenital heart disease, prevalence, abnormalities, etiology. Artigo submetido em 28.09.07, aceito em 06.11.07.

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“…1 and 2, the Baltimore-Washington Infant Study, and the New England Regional Infant Cardiac Program are but some of the important summaries of clinical outcomes addressing both specific lesions and outcomes of infants with congenital heart disease in disparate areas of the United States. [155][156][157][158][159][160] Other strategies to reduce mortality and to enhance cohort inclusion are regionalization and the development of standards for practice. [161][162][163][164] There is increasing evidence that regionalization can reduce surgical mortality and thus enhance outcomes.…”

Section: Outcome Analysis In Congenital Heart Diseasementioning

confidence: 99%