Retrospective evaluation of mortality due to congenital heart disease in the neonatal intensive care unit

Abstract

Objective: Congenital heart disease (CHD) is one of the most common congenital anomalies and a leading cause of neonatal morbidity and mortality. Early identification of risk factors associated with mortality in affected newborns is essential for improving outcomes. This study aimed to determine the prevalence, mortality rate, and independent risk factors associated with mortality among newborns with CHD admitted to the neonatal intensive care unit (NICU). Material and Methods: This retrospective study examined newborns with CHD followed up in the NICU of Medeniyet University, Göztepe Training and Research Hospital between January 2010 and January 2014. Sociodemographic, perinatal, and clinical data were extracted from a detailed review of medical records. Results: The prevalence of CHD was 6.5% in 3023 neonates followed up in the NICU. The most common CHD types were PDA (21.3%), PFO (15.7%), and VSD (14.2%). The mortality rate in newborns with CHD was 13.2% (n=26). Factors independently associated with mortality in these newborns included a low first-minute Apgar score (OR: 0.777, p=0.039), hypoplastic left heart syndrome (OR: 19.397, p=0.005), cardiomyopathy (OR: 7.607, p=0.042), and the need for endotracheal intubation (OR: 9.731, p=0.005). Conclusion: The prevalence of CHD diagnosis in our NICU setting was 6.5%, and the mortality rate in these newborns was 13.2%. Neonates with low Apgar scores, hypoplastic left heart syndrome, cardiomyopathy, and those undergoing endotracheal intubation should be monitored closely to allow for prompt life-saving interventions. Larger population-based studies are warranted to improve perinatal and postnatal management strategies for CHD.