Mortality and morbidity in preterm infants with congenital heart disease

Aim: To compare in-hospital mortality and rates of necrotising enterocolitis (NEC), sepsis, IVH and length of invasive respiratory support in preterm infants <36 weeks' gestation with congenital heart disease (CHD) to matched preterm infants without CHD in a single London centre over 13-year period.

Methods: Single-centre retrospective case-control study over the 13-year period from May 2004 to May 2017.

Results: Two hundred forty-seven preterm infants with CHD were matched to 494 infants without CHD. Patients with CHD had a significantly increased risk of in-hospital mortality compared to controls (OR 7.39 (95% CI 4.37-12.5); p < 0.001). Preterm infants with CHD had a higher risk of NEC (OR 2.42 (95% CI 1.32-4.45); p = 0.005), sepsis (OR 1.68 (95% CI 1.23-2.28); p = 0.001) and invasive respiratory support ≥28 days (OR 2.34 (95% CI 1.19-4.58); p = 0.017). Risk of IVH was lower in preterm infants with CHD (OR 0.22 (95% CI 0.11-0.42); p = 0.0001).

Conclusion: Preterm birth with CHD is associated with a higher risk of in-hospital mortality, NEC, sepsis and prolonged invasive respiratory support, but a lower risk of IVH compared to matched controls. In-hospital mortality remains high in moderate-to-late preterm infants with CHD.