Birth weight and prematurity in infants with single ventricle physiology: pediatric heart network infant single ventricle trial screened population.
OBJECTIVE
Although congenital heart disease is associated with low birth weight and prematurity, there is little information about these birth outcomes in infants with single ventricle physiology. We describe the birth outcomes (i.e., gestational age and birth weight) in neonates with single ventricle physiology screened for enrollment in the Pediatric Heart Network's Infant Single Ventricle Trial, compare these outcomes with US norms, and examine the association of birth outcomes with anatomic diagnosis and race.


METHODS
All neonates with single ventricle physiology presenting to Infant Single Ventricle Trial centers were screened for enrollment. Demographic data and anatomic diagnoses were obtained from medical records.


RESULTS
A total of 1245 neonates with single ventricle physiology were screened at 10 centers (63 to 266 per center). Diagnoses included hypoplastic left heart syndrome in 49%, unbalanced atrioventricular septal defect in 12%, and tricuspid atresia in 9%. Preterm birth occurred in 16% of neonates with single ventricle physiology vs. 12% in normal neonates (P < .001), low birth weight (<2.5 kg) in 18% vs. 8% in normals (P < .001), and small for gestational age (<10th percentile by definition) in 22% vs. 10% in normals (P < .001). A genetic syndrome was reported in 8%. The percentage of preterm birth, low birth weight, and small for gestational age was similar between screened neonates with and without hypoplastic left heart syndrome.


CONCLUSIONS
In this large, contemporary cohort of neonates with single ventricle physiology, rates of preterm birth, low birth weight, and small for gestational age were higher than in the general population, but similar between screened neonates with and without hypoplastic left heart syndrome.
Williams
Richard V
RV
Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA. richard.williams@imail.org
Ravishankar
Chitra
C
Zak
Victor
V
Evans
Frank
F
Atz
Andrew M
AM
Border
William L
WL
Levine
Jami
J
Li
Jennifer S
JS
Mahony
Lynn
L
Mital
Seema
S
Pearson
Gail D
GD
Prakash
Ashwin
A
Hsu
Daphne T
DT
D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications*; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008297:Male; D016032:Randomized Controlled Trials as Topic
Eur J Cardiothorac Surg. 2002 Apr;21(4):716-20
11932173
Am J Epidemiol. 1996 Mar 1;143(5):505-13
8610666
Ann Thorac Surg. 2006 Oct;82(4):1252-7; discussion 1258-9
16996917
Lancet. 1982 Feb 6;1(8267):312-4
6120316
J Thorac Cardiovasc Surg. 2008 Mar;135(3):546-51
18329467
Pediatrics. 1980 Feb;65(2 Pt 2):375-461
7355042
Am Heart J. 2009 Jan;157(1):37-45
19081394
Paediatr Perinat Epidemiol. 2007 Sep;21 Suppl 2:41-9
17803617
Obstet Gynecol. 1995 Aug;86(2):200-8
7617350
J Am Coll Cardiol. 1993 Jun;21(7):1722-6
8496543
J Am Coll Cardiol. 2007 Nov 6;50(19):1876-83
17980255
J Thorac Cardiovasc Surg. 2006 Feb;131(2):412-7
16434272
Stat Med. 2001 Dec 15;20(23):3491-503
11746333
Pediatrics. 2004 Mar;113(3 Pt 1):515-21
14993543
J Pediatr. 2002 Oct;141(4):538-42
12378194
Cardiol Young. 2000 May;10(3):193-200
10824898
Paediatr Perinat Epidemiol. 2002 Apr;16(2):181-7
12064271
Am J Med Genet. 2000 Winter;97(4):319-25
11376444
Pediatrics. 2007 Apr;119(4):e976-82
17387169
Pediatrics. 2005 Dec;116(6):e833-8
16322141
Teratology. 2002 Mar;65(3):106-15
11877773
Am J Epidemiol. 1991 Jun 15;133(12):1273-81
2063835
Eur J Clin Nutr. 1998 Jan;52 Suppl 1:S59-64
9511021
Eur J Cardiothorac Surg. 2002 Jul;22(1):82-9
12103378
Birth Defects Res A Clin Mol Teratol. 2006 Nov;76(11):747-56
17051527