Prognosis of the Newborns with Congenital Heart Diseases

摘要

Background: Congenital heart disease (CHD) is defined as problems affecting the heart of the fetus. According to previous studies, the incidence rate varies from 4-12 in 1000 live births. This study aimed to evaluate the demographic characteristics, clinical presentations, and findings that have impact on the prognosis of newborns hospitalized in Tabriz children Hospital, northwest of Iran. Methods: This cross-sectional study was conducted on 82 neonates with CHD admitted in Tabriz children Hospital, northwest of Iran from December 2011 to December 2012. Demographic characteristics, main complaints, symptoms, clinical presentations, associated anomalies, diagnoses, and also the correlation between the treatment process and mortality were evaluated. All data were analyzed using SPSS? version 16 statistical software. Results: A total of 82 neonates with CHD were enrolled. The mean age and birth weight were 8.54 days and 2828.17 grams, respectively. The most common chief complaint was respiratory distress (58 cases, 70.73%). The most common diagnosis was d-transposition of great arteries and the most frequent therapeutic procedure was medical therapy in combination with mechanical ventilation (31 cases, 37.8%). 10 neonates (12.1%) had complications while seizure was the most common complication of the study (4 case, 4.87%). Of 82 newborns in this study, 30 patients (36.6%) died of which 13 cases (43.33%) had DTGA; the most common therapeutic procedure was mechanical ventilation plus medical therapy which was performed in 22 patients (73.33%). In our study, no significant correlation could be observed between age, sex or weight of neonates and final outcome. Conclusion: Mortality of neonates with critical CHD is high. Also, the neonates treated with more invasive methods have higher mortality rates. It is obvious that both early detection and timely management affect ultimate prognosis of these patients. Hence, prenatal (fetal echocardiography) and postnatal (pulse oximetry and echocardiography) diagnostic evaluations and instituting appropriate referral system are crucial. Furthermore, establishment of neonatal and pediatric intensive care and pediatric cardiac, cardiac surgery and catheterization laboratory units in the same tertiary center is suggested.