Spectrum of Common Congenital Heart Diseases in Preterm Neonates
DOI:
https://doi.org/10.36570/jduhs.2022.2.1586Keywords:
Congenital Heart Disease, Preterm Newborns, Heart Disease, EchocardiographyAbstract
Objective: To determine the frequency and clinical spectrum of common congenital heart disease (CHD) in preterm newborns attending public sector tertiary care hospital.
Methods: A descriptive cross-sectional study was conducted at Neonatal Intensive Care Unit (NICU) of Liaquat National Hospital Karachi from October 2016 to March 2017. Record of preterm newborns having gestational age ≤37 weeks admitted to NICU were included. Cardiovascular examination and echocardiography were performed. If a defect was discovered on echocardiography, the type of CHD was also documented. CHD was labeled as positive based on the presence of anyone of the following: visual septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA) and tetralogy of fallot (TAF).
Results: Of 106 patients, CHD was observed in 21 (19.8%) cases. Of these, VSD was found in 8 (38.1%), ASD in 5 (23.8%), while PDA and TOF in 4 (19%) each. A significant association of CHD was observed with birth weight (p-value <0.001), history of CHD in siblings (p-value <0.001), consanguinity (p-value 0.005), and history of unexplained deaths in siblings (p-value 0.011). The mean birth weight was found significantly higher among neonates without CHD as compared to the neonates with CHD i.e., 2.83 ± 0.61 kg vs. 2.05 ± 0.56 kg (p-value <0.001).
Conclusion: The current study findings revealed that twenty percent of the preterm neonates admitted in NICU had CHD. Furthermore, an increased risk of CHD was observed in premature low birth weight neonates, those with history of CHD in siblings, history of unexplained deaths in siblings, and consanguineous marriage.
Downloads
References
GBD 2017 Congenital Heart Disease Collaborators. Global, regional, and national burden of congenital heart disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Child Adolesc Health 2020; 4:185-200. doi: 10.1016/S2352-4642(19)30402-X
Hussain S, Sabir MU, Afzal M, Asghar I. Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital. J Pak Med Assoc 2014; 64:175-8.
Khurshid A, Rashid J. Neonatal mortality in a district hospital setup. Ann King Edw Med Univ 2005; 11.373-6. doi.org/10.21649/akemu.v11i4.1055
Laas E, Lelong N, Ancel PY, Bonnet D, Houyel L, Magny JF, et al. Impact of preterm birth on infant mortality for newborns with congenital heart defects: The EPICARD population-based cohort study. BMC Pediatr 2017; 17:124. doi: 10.1186/s12887-017-0875-z
Rashid U, Qureshi AU, Hyder SN, Sadiq M. Pattern of congenital heart disease in a developing country tertiary care center: Factors associated with delayed diagnosis. Ann Pediatr Cardiol 2016; 9:210-5. doi: 10.4103/0974-2069.189125
Jatav RK, Kumbhare MB, Srinivas M, Rao DR, Kumar PG, Reddy PR, et al. Prevalence and pattern of CHD in Karimnagar, Andhra Paradesh, India: diagnosed clinically and by trans-thorasis-two dimensional echocardiography. Int J Res Med Sci 2014; 2:186-92.
Khawahur HA, Sowaiket HA, Saffar TA, Alzaher G, Dar-wich A, Qatary KA. The Pattern of CHD among Neonates Referred for Echocardiography. Bahrain Med Bull 2014; 36:86-9.
Harshangi SV. Clinical study of CHD in infants. J Pharmaceutical Sci Inn 2013; 2:15-8.
Musa NL, Hjortdal V, Zheleva B, Murni IK, Sano S, Schwartz S, et al. The global burden of paediatric heart disease. Cardiol Young 2017; 27:S3-S8. doi: 10.1017/S1047951117002530
Wu W, He J, Shao X. Incidence and mortality trend of congenital heart disease at the global, regional, and national level, 1990-2017. Medicine (Baltimore) 2020; 99:e20593. doi: 10.1097/MD.0000000000020593
Zimmerman M, Smith A, Sable CA, Echko M, Naghavi M, Hugo-Hamman C, et al. Relative impact of congenital heart disease on morbidity and mortality in infancy around the globe: the Global Burden of Disease Study. Circulation 2017; 136:A14666.
Almawazini AM, Hanafi HK, Madkhali HA, Majrashi NB. Effectiveness of the critical congenital heart disease screening program for early diagnosis of cardiac abnormalities in newborn infants. Saudi Med J 2017; 38:1019-24. doi: 10.15537/smj.2017.10.20295
Chakraborty A, Gorla SR, Swaminathan S. Impact of prenatal diagnosis of complex congenital heart disease on neonatal and infant morbidity and mortality. Prenat Diagn 2018; 38:958-63. doi: 10.1002/pd.5351
Geggel RL. Diagnosis and initial management of cyan-otic heart disease in the newborn. U: UpToDate, Armsby C ed. UpToDate [Internet]. Walthman, MA: UpToDate. 2021.
Peterson JK, Evangelista LS. Developmentally Supportive Care in Congenital Heart Disease: A Concept Analysis. J Pediatr Nurs 2017; 36: 241-7. doi: 10.1016/j.pedn.2017.05.007
Lloyd DF, Goreczny S, Austin C, Hussain T, Qureshi SA, Rosenthal E, et al. Catheter, MRI and CT Imaging in Newborns with Pulmonary Atresia with Ventricular Septal Defect and Aortopulmonary Collaterals: Quantifying the Risks of Radiation Dose and Anaesthetic Time. Pediatr Cardiol 2018; 39:1308-14. doi: 10.1007/s00246-018-1895-7
Cho SY, Oh JH, Lee JH, Lee JY, Lee SJ, Han JW, et al. Recent incidence of congenital heart disease in neonatal care unit of secondary medical center: a single center study. Korean J Pediatr 2012; 55:232-7. doi: 10.3345/kjp.2012.55.7.232
Wren C, O'Sullivan JJ. Survival with congenital heart disease and need for follow up in adult life. Heart 2001; 85:438-43. doi: 10.1136/heart.85.4.438
Best KE, Tennant PW, Rankin . Survival, by Birth Weight and Gestational Age, in Individuals With Congenital Heart Disease: A Population-Based Study. J Am Heart Assoc 2017; 6:e005213. doi: 10.1161/JAHA.116.005213
Parker R, Houghton S, Bichard E, McKeever S. Impact of congenital heart disease on siblings: A review. J Child Health Care 2020; 24:297-316. doi: 10.1177/1367493520914738
Ravindran VP, Rempel GR. Grandparents and siblings of children with congenital heart disease. J Adv Nurs 2011; 67:169-75. doi: 10.1111/j.1365-2648.2010.05482.x
Shieh JT, Bittles AH, Hudgins L. Consanguinity and the risk of congenital heart disease. Am J Med Genet A 2012; 158A:1236-41.doi: 10.1002/ajmg.a.35272
Wu MH, Chen HC, Lu CW, Wang JK, Huang SC, Huang SK. Prevalence of congenital heart disease at live birth in Taiwan. J Pediatr 2010; 156:782-5. doi: 10.1016/j.jpeds.2009.11.062
Roguin N, Du ZD, Barak M, Nasser N, Hershkowitz S, Milgram E. High prevalence of muscular ventricular septal defect in neonates. J Am Coll Cardiol 1995; 26:1545-8. doi: 10.1016/0735-1097(95)00358-4
Du ZD, Roguin N, Barak M, Bihari SG, Ben-Elisha M. High prevalence of muscular ventricular septal defect in preterm neonates. Am J Cardiol 1996; 78:1183-5. doi: 10.1016/s0002-9149(96)90080-6
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Sana Shabbir, Neelum Tahirkheli , Kashif Abbas, Samina Shamim
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
