Clinical outcomes in very low birth weight XXXX with major congenital heart defects.

@entity1 @entity474 @entity1498 @entity299 @entity472
BACKGROUND: The combination of major @entity299 ( @entity299 ) and prematurity is associated with poor prognosis, but previous studies have not fully characterized morbidity and mortality in this population. We conducted a retrospective cohort study of very low birth weight (VLBW) @entity1 with major @entity299 to describe outcomes, including mortality, over time. METHODS: We included all @entity1 <1500g birth weight with major @entity299 discharged from Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. We report incidences of major @entity299 in VLBW @entity1 and compare mortality and morbidity by @entity1 birth weight, type of major @entity299 , and time period. RESULTS: Of 105,539 VLBW @entity1 , 299 (0.3%) were diagnosed with 15 different major CHDs. @entity1498 (n=67, 22%), @entity474 (n=58, 19%), and tetralogy of Fallot (n=53, 18%) were the most common major CHDs identified. Overall mortality was 163/299 (55%). Mortality was >= 70% for 10 lesions and <30% for isolated @entity472 (6/30, 20%). Mortality in @entity1 with major @entity299 did not significantly change over time: 76/133 (57%) in 1997-2005, 49/95 (52%) in 2006-2009, and 38/71 (54%) in 2010-2012 (p=0.70). The majority of @entity1 suffered >= 1 comorbidity or died (218/299, 73%). CONCLUSION: Major @entity299 is associated with high morbidity and mortality. While mortality varies by lesion, overall survival and incidence of major morbidity have not improved over time.
