Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis
Mortality outcomes of children with isolated neonatally operated congenital heart defects (CHDs) born with a low (LBW), moderately low (MLBW) or very-low birthweight (VLBW) remain ambiguous. We searched Medline and Embase (inception until October 2021) and included studies that evaluated early morta...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/2/47 |
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| author | Neil Derridj Ali Ghanchi Damien Bonnet Pauline Adnot Makan Rahshenas Laurent J. Salomon Jérémie F. Cohen Babak Khoshnood |
| author_facet | Neil Derridj Ali Ghanchi Damien Bonnet Pauline Adnot Makan Rahshenas Laurent J. Salomon Jérémie F. Cohen Babak Khoshnood |
| author_sort | Neil Derridj |
| collection | DOAJ |
| description | Mortality outcomes of children with isolated neonatally operated congenital heart defects (CHDs) born with a low (LBW), moderately low (MLBW) or very-low birthweight (VLBW) remain ambiguous. We searched Medline and Embase (inception until October 2021) and included studies that evaluated early mortality. The risk of bias was assessed using the Critical Appraisal Skills Program cohort checklist. Meta-analysis involved random-effects models. We explored variability in mortality across birthweight subgroups, CHD types, and study designs. From 2035 reports, we included 23 studies in qualitative synthesis, and the meta-analysis included 11 studies (1658 CHD cases), divided into 30 subcohorts. The risk of bias was low in 4/11 studies included in the meta-analysis. Summary mortality before discharge or within one month after surgery was 37% (95%CI 27–47). Early mortality varied by birthweight (VLBW 56%, MLBW 15%, LBW 16%; <i>p</i> = 0.003) and CHD types (hypoplastic left heart syndrome (HLHS) 50%, total anomalous pulmonary venous return (TAPVR) 47%, transposition of the great arteries (TGA) 34%, coarctation of the aorta (CoA) 16%; <i>p</i> = 0.13). Mortality was higher in population-based studies (49% vs. 10%; <i>p</i> = 0.006). One-third of infants born with neonatally operated isolated CHDs and LBW, MLBW, or VLBW died within 30 days after surgery. Mortality varied across infant and study characteristics. These results may help clinicians assess neonatal prognosis. PROSPERO registration CRD42020170289. |
| first_indexed | 2024-03-11T08:38:40Z |
| format | Article |
| id | doaj.art-62195c6fc85245f78f1efd2329ee1e5c |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T08:38:40Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-62195c6fc85245f78f1efd2329ee1e5c2023-11-16T21:16:17ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-01-011024710.3390/jcdd10020047Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-AnalysisNeil Derridj0Ali Ghanchi1Damien Bonnet2Pauline Adnot3Makan Rahshenas4Laurent J. Salomon5Jérémie F. Cohen6Babak Khoshnood7Centre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, FranceCentre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, FranceM3C-Necker, National Reference Center for Complex Congenital Heart Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, FranceDepartment of General Pediatrics and Pediatric Infectious Diseases, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, FranceCentre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, FranceDepartment of Obstetrics and Fetal Medicine, APHP, Université Paris Cité, Hôpital Necker-Enfants Malades, CEDEX 15, 75743 Paris, FranceCentre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, FranceCentre of Research in Epidemiology and Statistics (Inserm 1153, CRESS), Université Paris Cité, 75004 Paris, FranceMortality outcomes of children with isolated neonatally operated congenital heart defects (CHDs) born with a low (LBW), moderately low (MLBW) or very-low birthweight (VLBW) remain ambiguous. We searched Medline and Embase (inception until October 2021) and included studies that evaluated early mortality. The risk of bias was assessed using the Critical Appraisal Skills Program cohort checklist. Meta-analysis involved random-effects models. We explored variability in mortality across birthweight subgroups, CHD types, and study designs. From 2035 reports, we included 23 studies in qualitative synthesis, and the meta-analysis included 11 studies (1658 CHD cases), divided into 30 subcohorts. The risk of bias was low in 4/11 studies included in the meta-analysis. Summary mortality before discharge or within one month after surgery was 37% (95%CI 27–47). Early mortality varied by birthweight (VLBW 56%, MLBW 15%, LBW 16%; <i>p</i> = 0.003) and CHD types (hypoplastic left heart syndrome (HLHS) 50%, total anomalous pulmonary venous return (TAPVR) 47%, transposition of the great arteries (TGA) 34%, coarctation of the aorta (CoA) 16%; <i>p</i> = 0.13). Mortality was higher in population-based studies (49% vs. 10%; <i>p</i> = 0.006). One-third of infants born with neonatally operated isolated CHDs and LBW, MLBW, or VLBW died within 30 days after surgery. Mortality varied across infant and study characteristics. These results may help clinicians assess neonatal prognosis. PROSPERO registration CRD42020170289.https://www.mdpi.com/2308-3425/10/2/47congenital heart defectssystematic reviewmeta-analysislow birth weighthypoplastic left heart syndromemortality |
| spellingShingle | Neil Derridj Ali Ghanchi Damien Bonnet Pauline Adnot Makan Rahshenas Laurent J. Salomon Jérémie F. Cohen Babak Khoshnood Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis Journal of Cardiovascular Development and Disease congenital heart defects systematic review meta-analysis low birth weight hypoplastic left heart syndrome mortality |
| title | Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis |
| title_full | Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis |
| title_fullStr | Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis |
| title_short | Early Mortality in Infants Born with Neonatally Operated Congenital Heart Defects and Low or Very-Low Birthweight: A Systematic Review and Meta-Analysis |
| title_sort | early mortality in infants born with neonatally operated congenital heart defects and low or very low birthweight a systematic review and meta analysis |
| topic | congenital heart defects systematic review meta-analysis low birth weight hypoplastic left heart syndrome mortality |
| url | https://www.mdpi.com/2308-3425/10/2/47 |
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