Retrospective assessment of newborns with congenital heart defects

Abstract

Aim. The research was to study peculiarities of clinical and functional characteristics of newborn children with congenital heart defects. Material and Methods. A retrospective analysis of medical records with analysis of the children's status at birth during early neonatal period was conducted with assessment of anthropometric indicators of newborn children with congenital heart defects that had been the core group for the period of 2011-2015, and the figures were compared with those in the control group of healthy newborns. The study was based on data obtained in the Maternity Department of Lviv Regional Clinical Hospital, where women with congenital disorders of the fetus are hospitalized and pregnant women with extragenital pathology from Lviv region are treated. Results and Discussion. In the maternity department, over the period of 5 years 172 children were born with congenital heart defects among 15429 children born alive. The frequency of pathology was 1.1. Among the newborns in both groups there was no significant difference in the number of male and female children. In the control group all children were full-term, while in the main group, 16.7% of the children were preterm (p<0.05). In the group of children with congenital heart disease there were children with low weight for gestational age and there was a significantly higher number of children whose height was 40-44 cm in comparison with healthy children (p<0.05). The Apgar score for the children of the main group at birth was satisfactory - 10-8 points - 94 children (54.7%); with hypoxia, 7-6 points - 67 (38.9%) of the infants; and 11 (6,4%) children were born with severe hypoxia. Almost half (47.1%) of the children with congenital.heart defects were placed in specialized intensive care units. There were 3 (1.7%) fatal cases during the first days after birth. In the main group only 17 (9.9%) cases had complications in the early neonatal period. Among 172 children with congenital heart defects, 28 (16.3%) had concomitant congenital pathology, the most frequently - multiple congenital malformations - 12 (7.0%), chromosomal disorders - 7 (4.1%) and congenital central nervous disease - 6 (3.5%). Analysis of the results of genetic counseling of the mothers of children with congenital heart disease showed that in 69 (40.1%) children the disease was identified antepartum, and for 103 (59.9%) it was not diagnosed. in 8 (4.7%) cases an invasive prenatal diagnosis was recommended due to suspected chromosomal pathology. Conclusions. The results indicate that the anthropometric parameters in newborn infants with congenital heart disease, whose early neonatal period was often complicated, differ from the same indicators in healthy newborns. The tendency of light weight at birth for children with congenital heart defects was determined. Newborns with congenital heart diseases (47.1%) required resuscitation at birth and were transferred to specialized departments for further treatment. Medical genetic counseling of the mothers of children with congenital heart defects had been conducted in 69 (40.1%) cases, and cardiac disease was identified before birth. In almost 60% of cases the congenital heart defect was not detected before delivery. In 8 (4.7%) cases it was recommended to perform invasive prenatal diagnosis due to suspected chromosomal pathology. So, the procedure of genetic counseling for early diagnosis of the specified pathology requires improvement to prevent complications of the perinatal period.

Keywords

• congenital heart diseases, newborn children, retrospective analysis