Congenital heart defects and preterm birth: Outcomes from a referral center

Rev Port Cardiol. 2023 May;42(5):403-410. doi: 10.1016/j.repc.2022.05.009. Epub 2023 Feb 23.
[Article in English, Portuguese]

Abstract

Background: Preterm birth and congenital heart defects are two major causes of neonatal and infant mortality. However, the relationship between them has not yet been fully clarified.

Objective: To determine the prevalence and spectrum of congenital heart defects in preterms, the specific associations between categories of congenital heart defects and preterm birth and to establish the influence on outcomes.

Methods: Observational, case-control analysis that included 448 live births with congenital heart defects born between 2003 and 2017. Preterm with congenital heart defects were the case subjects and term neonates with congenital heart defects the control subjects.

Results: Of the newborns with congenital heart defects, 23% were preterm. The odds of congenital heart defects in preterm were twofold higher than for term neonates (p<0.0001), even when considering only those with severe congenital heart defects (p=0.0002). The odds in preterm were 9.2-fold higher for abnormalities of the atria and atrial septum (p<0.0001) and two-fold higher for abnormalities of the ventricles and ventricular septum (p<0.0001) compared with term neonates. The neonatal mortality rate in the preterm group was not statistically different from that of the term group with congenital heart defects (p=0.799) or severe congenital heart defects (p=0.554).

Conclusion: Preterm have more than twice as many congenital heart defects as term neonates. Although the etiology of prematurity between infants with congenital heart defects is still uncertain, our findings highlight a possible relationship between prematurity and congenital heart defects.

Keywords: Cardiopatia congénita; Congenital heart defect; Echocardiography; Ecocardiografia; Epidemiologia; Epidemiology; Morbidity; Morbilidade; Mortalidade; Mortality; Prematuridade; Preterm birth.

Publication types

  • Observational Study

MeSH terms

  • Female
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Prevalence
  • Referral and Consultation