Clinical outcomes in neonates with congenital heart disease with concurrent congenital neurological anomalies

Abstract

Introduction: Children with congenital heart diseases(CHD) may be born with major extracardiac congenital anomalies. We hypothesized that neonates with CHD with concurrent central nervous system congenital lesions (CNS) experience worse clinical outcomes compared to those with isolated CHD.

Methods: We used the National Inpatient Sample database for the years 2016-2020 to examine the incidence of CHD and CNS lesions among neonates. We further categorized CHD into simple lesions, complex biventricular lesions, and single ventricle lesions. We used descriptive statistics to compare the characteristics of neonates with isolated CHD vs. those with central nervous system anomalies. We then created logistic regression models accounting for important confounding factors to calculate the risk of central nervous system anomalies in outcomes in neonates with CHD.

Results: We retrieved 564,085 neonates with CHD and found 22,065 with concurrent CNS lesions. In-hospital mortality was significantly higher in combined CHD and CNS cases 9.0%(n = 1990) vs. isolated CHD 2.5%, (n = 13710), P = 0.001. Mortality was higher in those children who underwent surgical repair vs. those without surgical repair for CHD for each category of CHD severity. Major clinical complications were more frequent in cases with CNS involvement.

Conclusions: Neonates born with CHD and CNS anomalies experience higher morbidity and mortality compared to those with isolated CHD.

Keywords: Central nervous system anomalies; Clinical outcomes; Congenital heart disease; International classification of diseases; Tenth revision; United states.