Marantz Pablo, Sáenz Tejeira M Mercedes, Peña Gabriela, Segovia Alejandra, Fustiñana Carlos
Hospital ltaliano de Buenos Aires, Buenos Aires, Argentine.
Arch Argent Pediatr. 2013 Oct;111(5):418-22. doi: 10.5546/aap.2013.eng.418.
Congenital malformations are a known cause of intrauterine death; of them, congenital heart diseases (CHDs) are accountable for the highest fetal and neonatal mortality rates. They are strongly associated with other extracardiac malformations and an early fetal mortality. Two hundred and twenty fves cases of CHDs are presented. Of them, 155 were isolated CHDs (group A) and 70 were associated with extracardiac malformations, chromosomal disorders, or genetic syndromes (group B). The overall mortality in group B was higher than that observed in group A (p <0.01). Prenatal mortality was similar in both groups: A: 8.4% (13 out of 155); B: 15.7% (11 out of 70). Postnatal mortality was A: 16.8% (26 out of 155) (p <0.01), OR: 0.52 (95% CI: 0.16-1.7); B: 32.9% (23 out of 70) (p <0.01), OR: 0.41 (95% CI: 0.20-0.83). Heart diseases associated with extracardiac abnormalities had a higher mortality rate than isolated congenital heart diseases in the period up to 60 weeks of postmenstrual age (140 days post-term). No differences were observed between both groups of patients in terms of prenatal mortality.
先天性畸形是已知的宫内死亡原因；其中，先天性心脏病（CHD）导致的胎儿和新生儿死亡率最高。它们与其他心外畸形及早期胎儿死亡密切相关。本文报告了225例先天性心脏病病例。其中，155例为单纯先天性心脏病（A组），70例合并心外畸形、染色体疾病或遗传综合征（B组）。B组的总体死亡率高于A组（p<0.01）。两组的产前死亡率相似：A组为8.4%（155例中有13例）；B组为15.7%（70例中有11例）。产后死亡率A组为16.8%（155例中有26例）（p<0.01），比值比（OR）为0.52（95%置信区间：0.16 - 1.7）；B组为32.9%（70例中有23例）（p<0.01），OR为0.41（95%置信区间：0.20 - 0.83）。在月经龄60周（孕40周后140天）之前，合并心外异常的心脏病患者死亡率高于单纯先天性心脏病患者。两组患者在产前死亡率方面未观察到差异。
