Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis.
Derridj, Neil; GHANCHI, Ali; Bonnet, Damienet al.
2023 • In Journal of Cardiovascular Development and Disease, 10 (2), p. 47
coarctation of the aorta; congenital heart defects; hypoplastic left heart syndrome; low birth weight; meta-analysis; mortality; systematic review; total anomalous pulmonary venous return; transposition of the great arteries; Pharmacology, Toxicology and Pharmaceutics (all); Pharmacology (medical)
Abstract :
[en] Mortality outcomes of children with isolated neonatally operated congenital heart defects (CHDs) born with a low (LBW), moderately low (MLBW) or very-low birthweight (VLBW) remain ambiguous. We searched Medline and Embase (inception until October 2021) and included studies that evaluated early mortality. The risk of bias was assessed using the Critical Appraisal Skills Program cohort checklist. Meta-analysis involved random-effects models. We explored variability in mortality across birthweight subgroups, CHD types, and study designs. From 2035 reports, we included 23 studies in qualitative synthesis, and the meta-analysis included 11 studies (1658 CHD cases), divided into 30 subcohorts. The risk of bias was low in 4/11 studies included in the meta-analysis. Summary mortality before discharge or within one month after surgery was 37% (95%CI 27-47). Early mortality varied by birthweight (VLBW 56%, MLBW 15%, LBW 16%; p = 0.003) and CHD types (hypoplastic left heart syndrome (HLHS) 50%, total anomalous pulmonary venous return (TAPVR) 47%, transposition of the great arteries (TGA) 34%, coarctation of the aorta (CoA) 16%; p = 0.13). Mortality was higher in population-based studies (49% vs. 10%; p = 0.006). One-third of infants born with neonatally operated isolated CHDs and LBW, MLBW, or VLBW died within 30 days after surgery. Mortality varied across infant and study characteristics. These results may help clinicians assess neonatal prognosis. PROSPERO registration CRD42020170289.
Disciplines :
Pediatrics
Author, co-author :
Derridj, Neil; Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, France ; M3C-Necker, National Reference Center for Complex Congenital Heart Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
GHANCHI, Ali ; University of Luxembourg ; Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, France ; Department of Obstetrics and Fetal Medicine, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
Bonnet, Damien ; M3C-Necker, National Reference Center for Complex Congenital Heart Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
Adnot, Pauline; Department of General Pediatrics and Pediatric Infectious Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
Rahshenas, Makan; Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, France
Salomon, Laurent J; Department of Obstetrics and Fetal Medicine, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
Cohen, Jérémie F; Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, France ; Department of General Pediatrics and Pediatric Infectious Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, France
Khoshnood, Babak; Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, France
External co-authors :
yes
Language :
English
Title :
Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis.
APHP DRCI, Association pour la Recherche en Cardiologie du Foetus à l’Adulte (ARCFA) Féderation Francaise de Cardiologie (FFC)
Funding text :
This work is part of a PhD project funded by the APHP DRCI, Association pour la Recherche en Cardiologie du Foetus à l’Adulte (ARCFA), and the Féderation Francaise de Cardiologie (FFC).
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