The impact of prematurity and associated comorbidities on clinical outcomes in neonates with congenital heart disease |
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| Affiliation: | 1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, USA;2. Department of Surgery, Division of Cardiothoracic Surgery, Children''s Healthcare of Atlanta, Emory School of Medicine, USA;1. T.S. Park Chair and Chief of Pediatric Neurosurgery, Executive Vice Chair of Neurological Surgery, Washington University School of Medicine; Neurosurgeon-in-Chief, St. Louis Children''s Hospital;2. Em. Professor in Neonatal Neurology, Department of Neonatology, University Medical Center Utrecht and Leiden University Medical Center, the Netherlands;1. Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA;2. Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA;3. Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA;1. Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children''s Hospital, Palo Alto, CA, USA;2. Division of Cardiology, Departments of Pediatrics and Obstetrics, University of Colorado School of Medicine, Children''s Hospital Colorado, Aurora, CO, USA;1. University of Washington School of Medicine, Seattle Children''s Hospital, Seattle, WA, United States;2. Stanford University School of Medicine, Lucile Packard Children''s Hospital, Stanford, CA, United States;1. University of Alabama at Birmingham, Birmingham, AL, USA;2. University of Texas, Houston, TX, USA;3. RTI International, Research Triangle Park, NC, USA;4. University of Iowa, Iowa City, IA, USA |
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| Abstract: | Prematurity is a common risk factor in children, affecting approximately 10% of live births, globally. It is more common in children with critical congenital heart disease (CCHD) and carries important implications in this group of patients. While outcomes have been improving over the years, even late preterm birth is associated with worse outcomes in children born with critical congenital heart disease compared to those without. Infants with both prematurity and CCHD are at particularly high risk for important comorbidities, including: necrotizing enterocolitis, intraventricular hemorrhage, white matter injury, neurodevelopmental anomalies and retinopathy of prematurity. Lesion-specific intensive care management of these infants, interventional and peri-operative management specifically tailored to their needs, and multidisciplinary care all have the potential to improve outcomes in this challenging group. |
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