Department of Neonatology, Guy's and St. Thomas NHS Foundation Trust, London, UK.
Department of Paediatric Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Acta Paediatr. 2022 Jan;111(1):151-156. doi: 10.1111/apa.16155. Epub 2021 Nov 11.
To compare in-hospital mortality and rates of necrotising enterocolitis (NEC), sepsis, IVH and length of invasive respiratory support in preterm infants <36 weeks' gestation with congenital heart disease (CHD) to matched preterm infants without CHD in a single London centre over 13-year period.
Single-centre retrospective case-control study over the 13-year period from May 2004 to May 2017.
Two hundred forty-seven preterm infants with CHD were matched to 494 infants without CHD. Patients with CHD had a significantly increased risk of in-hospital mortality compared to controls (OR 7.39 (95% CI 4.37-12.5); p < 0.001). Preterm infants with CHD had a higher risk of NEC (OR 2.42 (95% CI 1.32-4.45); p = 0.005), sepsis (OR 1.68 (95% CI 1.23-2.28); p = 0.001) and invasive respiratory support ≥28 days (OR 2.34 (95% CI 1.19-4.58); p = 0.017). Risk of IVH was lower in preterm infants with CHD (OR 0.22 (95% CI 0.11-0.42); p = 0.0001).
Preterm birth with CHD is associated with a higher risk of in-hospital mortality, NEC, sepsis and prolonged invasive respiratory support, but a lower risk of IVH compared to matched controls. In-hospital mortality remains high in moderate-to-late preterm infants with CHD.
比较 13 年间伦敦单一中心 247 例患有先天性心脏病（CHD）的妊娠 36 周以下早产儿与 494 例无 CHD 的早产儿的院内死亡率和坏死性小肠结肠炎（NEC）、败血症、颅内出血（IVH）及有创性呼吸支持的发生率。
回顾性病例对照研究，时间为 2004 年 5 月至 2017 年 5 月，共 13 年。
247 例 CHD 早产儿与 494 例无 CHD 早产儿相匹配。与对照组相比，CHD 患儿的院内死亡率显著升高（OR 7.39（95%CI 4.37-12.5）；p<0.001）。CHD 早产儿发生 NEC（OR 2.42（95%CI 1.32-4.45）；p=0.005）、败血症（OR 1.68（95%CI 1.23-2.28）；p=0.001）和有创性呼吸支持≥28 天（OR 2.34（95%CI 1.19-4.58）；p=0.017）的风险更高。CHD 早产儿发生 IVH 的风险较低（OR 0.22（95%CI 0.11-0.42）；p=0.0001）。
与匹配对照组相比，CHD 早产儿的院内死亡率、NEC、败血症和有创性呼吸支持的时间延长的风险更高，但 IVH 的风险较低。患有中晚期 CHD 的早产儿的院内死亡率仍然较高。
