205: Predictors of adverse outcomes in infants with single ventricle physiology

Abstract

We aimedto investigate factors that are associated with adverse outcomes in newborns with prenatally diagnosed functional single ventricular heart physiology. This is a retrospective case-control study of 336 pregnancies diagnosed with congenital heart disease (CHD) between 2011 and 2016. Groups consisted of newborns who survived beyond age of four (control), and those who encountered postnatal mortality prior to that (study). Data included maternal and fetal characteristics, and postnatal outcomes.A p value of <0.05 was considered statistically significant. We identified 53/336 (15.7%) pregnancies with single ventricle physiology during the study period. Most common anatomical defects contributing to the single ventricle physiology were: hypoplastic right heart (HRH) (45.2%), hypoplastic left heart syndrome (HLHS) (32 %), pulmonary atresia and intact interventricular septum (PA-IVS) (9.4 %), unbalanced atrioventricular septal defect (AVSD) (9.4%), and double inlet left ventricle (DILV) (3.7 %). Significant factors associated with poor adverse outcomes included: hypoplastic left heart (P= 0.006), and delivery at less than 37 weeks (P= 0.03). Significant postnatal predictors of poor outcomes included pre-operative vasopressors use (P= 0.03) and post-operative Extracorporeal Membrane Oxygenation (ECMO) (P= 0.0001). Hypoplastic right heart was significantly associated with better postnatal outcomes (p= 0.0001). We found higher rate of postnatal mortality among newborns with single ventricle physiology in pregnancies delivered prior to 37 weeks gestation.