congenital heart defects; meta-analysis; population-based study; small for gestational age; systematic review; Female; Humans; Infant, Newborn; Pregnancy; Risk Factors; Fetal Growth Retardation; Heart Defects, Congenital; Infant, Small for Gestational Age; Parturition; Pollution; Public Health, Environmental and Occupational Health; Health, Toxicology and Mutagenesis
Abstract :
[en] [en] UNLABELLED: Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted.
OBJECTIVE: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA).
METHODS: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model.
RESULTS: The pooled proportion of SGA in all CHD was 20% (95% CI 16%-24%) and 14% (95% CI 13%-16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%-37%) for Tetralogy of Fallot to 12% (95% CI 7%-18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010.
CONCLUSION: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.
Disciplines :
Pediatrics
Author, co-author :
GHANCHI, Ali ; University of Luxembourg ; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France ; Service d'Obstétrique-Maternité, chirurgie médecine et imagerie fœtales, APHP, Hôpital Necker Enfants Malades, F-75015 Paris, France
Derridj, Neil; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France ; Department of Pediatric Cardiology, M3C-Necker, APHP, Hôpital Necker-Enfants Malades, F-75015 Paris, France
Bonnet, Damien; Department of Pediatric Cardiology, M3C-Necker, APHP, Hôpital Necker-Enfants Malades, F-75015 Paris, France
Bertille, Nathalie; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
Salomon, Laurent J; Service d'Obstétrique-Maternité, chirurgie médecine et imagerie fœtales, APHP, Hôpital Necker Enfants Malades, F-75015 Paris, France
Khoshnood, Babak; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
External co-authors :
yes
Language :
English
Title :
Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis.
Publication date :
28 April 2020
Journal title :
International Journal of Environmental Research and Public Health
Funding: Thesis project financed by APHP DRCI and Association pour la Recherche en Cardiologie du Foetus à l’Adulte (ARCFA).Thesis project financed by APHP DRCI and Association pour la Recherche en Cardiologie du Foetus ? l?Adulte (ARCFA). Catherine Weil.
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