The association between congenital heart disease and small for gestational age with regard to the prevalence and outcomes
The association between congenital heart disease and small for gestational age with regard to the prevalence and outcomes
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DOI：
10.1111/apa.15587
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发表时间：
2020-10-24
期刊：
影响因子：
3.8
通讯作者：
Iwashima, Satoru
中科院分区：
文献类型：
--
作者：
Ishikawa, Takamichi;Uchiyama, Hiroki;Iwashima, Satoru
目的：探讨小于胎龄儿(SGA)与先天性心脏病(CHD)患病率的关系及其与预后的关系。方法：对5664例出生后5天内的先天性心脏病患儿进行超声心动图检查。根据有无SGA和CHD将婴儿分为4组。对所有CHD婴儿进行随访，直到所有心脏病变自发消退、介入治疗或死亡。结果：共有303名新生儿被诊断为冠心病，610名被诊断为先天性心脏病。在CHD患儿中，SGA患儿56例，非SGA患儿247例。多因素Logistic回归分析显示，SGA的调整优势比(9.71，P&t；.001)显著高于其他与介入治疗或死亡预测因素有关的参数。SGA和CHD同时存在时的死亡率(危险比：33.6，P&t；.001)显著高于两者都不存在时的死亡率。结论：SGA是冠心病介入治疗的重要预测因子。CHD和SGA的合并带来了比单独的死亡风险更高的风险。
Aim: To evaluate the association between small for gestational age (SGA) and the prevalence of congenital heart disease (CHD) and the association of the SGA status with the outcomes among infants with CHD.Methods: Echocardiography was performed within the first 5 days of life in 5664 consecutive infants. Infants were classified into four groups according to the presence or absence of SGA and CHD. All CHD infants were followed up until either spontaneous resolution of all cardiac lesions, invasive intervention or death. All new-borns without CHD were followed for mortality until the final follow-up date.Results: A total of 303 infants were diagnosed with CHD, while 610 were diagnosed with SGA. Among the CHD infants, 56 were SGA, and 247 were not. A multivariable logistic regression analysis showed that the adjusted odds ratio of SGA (9.71, P < .001) was significantly higher than that of other parameters concerning predictors of invasive intervention or death. The mortality rate in the presence of both SGA and CHD (hazard ratio: 33.6, P < .001) was markedly higher than in the absence of both.Conclusion: SGA was a significant predictor of invasive intervention for CHD. The combination of CHD and SGA carried a high risk of death beyond that of either alone.