Gestational Age, Birth Weight, and Outcomes Six Years After the Norwood Procedure.

Document Type

Article

Publication Date

5-1-2019

Institution/Department

Pediatrics; Cardiology

Journal Title

Pediatrics

MeSH Headings

Birth Weight, Child, Child Development, Cohort Studies, Female, Gestational Age, Humans, Infant, Newborn, Male, Norwood Procedures, Time Factors, Treatment Outcome

Abstract

BACKGROUND: Preterm delivery and low birth weight (LBW) are generally associated with worse outcomes in hypoplastic left heart syndrome (HLHS), but an individual preterm or small neonate may do well. We sought to explore the interactions between gestational age, birth weight, and birth weight for gestational age with intermediate outcomes in HLHS.

METHODS: We analyzed survival, growth, neurodevelopment, length of stay, and complications to age 6 years in subjects with HLHS from the Single Ventricle Reconstruction trial. Univariate and multivariable survival and regression analyses examined the effects and interactions of LBW (g), weight for gestational age, and gestational age category.

RESULTS: Early-term delivery (

CONCLUSIONS: Preterm delivery in HLHS was associated with worse survival, even beyond Norwood hospitalization. LBW, SGA, and early-term delivery were associated with worse growth but not survival. LBW was associated with worse neurodevelopment, despite similar length of stay and complications. These data suggest that preterm birth and LBW (although often concomitant) are not equivalent, impacting clinical outcomes through mechanisms independent of perioperative course complexity.

ISSN

1098-4275

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