Godfrey Max, Schimmel Michael S, Hammerman Cathy, Farber Benjamin, Glaser Joram, Nir Amiram
Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.
Isr Med Assoc J. 2010 Jan;12(1):36-8.
The incidence of congenital heart defects, reported to be 5-8/1000 in term infants, is not well established in very low birth weight infants.
To establish the incidence of congenital heart defects in VLBW infants in the neonatal intensive care unit of our institution.
A retrospective analysis of the population in the NICU at our institution was performed. VLBW (BW < or = 1500 g) infants born between 2001 and 2006 who survived more than 48 hours were included in the study. Infants with clinical signs of heart disease underwent echocardiography.
During the study period 437 VLBW live-born infants met the inclusion criteria. Of these, 281 (64.3%) underwent echocardiography. CHD was detected in 19 infants (4.4%, 95% confidence interval 2.4-5.4%), significantly higher than the incidence of 5-8/1000 in the general population (P<0.0001). In the subgroup of 154 infants with BW < 1000 g there were 10 (6.5%) with CHD. In the subgroup of 283 infants with BW 100-1500 g there were 9 (3.2%, P= 0.19 vs. VLBW) with CHD.
Our observations show an increased incidence of CHD in VLBW neonates, as compared to the general population. Since not all infants underwent echocardiography, and minor cardiac defects may have been missed in our VLBW infants, the true incidence may be higher than reported here.
据报道,足月儿先天性心脏缺陷的发病率为5 - 8/1000,但极低出生体重儿的发病率尚未明确。
确定我院新生儿重症监护病房极低出生体重儿先天性心脏缺陷的发病率。
对我院新生儿重症监护病房的人群进行回顾性分析。纳入2001年至2006年间出生、体重≤1500g且存活超过48小时的极低出生体重儿。有心脏病临床体征的婴儿接受超声心动图检查。
在研究期间,437例极低出生体重活产婴儿符合纳入标准。其中,281例(64.3%)接受了超声心动图检查。19例婴儿(4.4%,95%置信区间2.4 - 5.4%)被检测出患有先天性心脏病,显著高于一般人群5 - 8/1000的发病率(P<0.0001)。在体重<1000g的154例婴儿亚组中,有10例(6.5%)患有先天性心脏病。在体重1000 - 1500g的283例婴儿亚组中,有9例(3.2%,与极低出生体重儿相比P = 0.19)患有先天性心脏病。
我们的观察结果显示,与一般人群相比,极低出生体重新生儿先天性心脏病的发病率有所增加。由于并非所有婴儿都接受了超声心动图检查,且我们的极低出生体重儿可能遗漏了一些轻微心脏缺陷,因此实际发病率可能高于此处报告的发病率。