AUTHOR=De Silvestro Alexandra , Reich Bettina , Bless Sarah , Sieker Julika , Hollander Willemijn , de Bijl-Marcus Karen , Hagmann Cornelia , Nijman Joppe , Knirsch Walter ,  the European Association Brain in Congenital Heart Disease , Bekker Mirielle N. , Benders Manon J. N. L. , Groenendaal Floris , Koopman-Esseboom Corine , Nijman Maaike , Stegeman Raymond , Bonthrone Alexandra , Chew Andrew , Counsell Serena J. , Cromb Daniel , Gal-Er Barat , Kelly Christopher J. , Pushparajah Kuberan , Bosch Rian , On Sergei Chin , Jansen Nicolaas J. G. , Slooff Valerie D. , Breur Johannes M. P. J. , Claessens Nathalie H. P. , Nijman Maaike , Stegeman Raymond , Dave Hitendu , Feldmann Maria , Kottke Raimund , Latal Beatrice , Steger Céline , Dave Hitendu , Feldmann Maria , Latal Beatrice , Haak Monique C. , Jansen Nicolaas J. G. , Stegeman Raymond , Kottke Raimund , Steger Céline 

TITLE=Morbidity and mortality in premature or low birth weight patients with congenital heart disease in three European pediatric heart centers between 2016 and 2020

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1323430

DOI=10.3389/fped.2024.1323430

ISSN=2296-2360

ABSTRACT=Background
Treatment of preterm and low birthweight (LBW) neonates born with congenital heart disease (CHD) requiring early cardiac intervention remains challenging. We aimed to analyze morbidity and mortality in this combined high-risk patient group.

Methods
Retrospective cohort study of preterm (<37 weeks gestational age (GA)) and/or LBW neonates (<2500g) born with a diagnosis of CHD which requires invasive cardiac intervention (surgery or catheter) within their first year of life. Patients born from 2016 to 2020, treated in three European pediatric heart centers were included.

Results
A total of 308 neonates (51% male) with CHD were included. Of those, 237 (77%) were born preterm, 259 (84%) LBW, and 188 (61%) were both. Median (IQR) GA was 35.4 (33.3-36.9) weeks and a mean (SD) birth weight was 2016 (580) grams. CHD was categorized as simple (12%), moderate (64%), or severe (24%). Overall complication rate was 45% and highest in patients with severe CHD (p=0.002). One-year mortality (19%) was associated with severe CHD type, low relative birth weight in patients with genetic diagnoses, and low GA at birth, whereas GA at birth significantly impacted survival only after three months of life.

Discussion
The high morbidity and mortality in preterm and LBW neonates with CHD reflect their complexity and consequent limited treatment feasibility.