P09.02: Comparison of neonatal outcomes with congenital heart diseases according to the place at birth

Abstract

To determine whether the neonatal outcomes are different between out-born and inborn neonates with congenital heart anomaly. We included 221 newborns with congenital heart diseases who admitted in neonatal intensive care unit at our institution. We classified the study samples into two groups according to the place at birth (out-born versus in-born) and classified the heart diseases into four categories (1: septal defects, 2: tetralogy of Fallot (TOF) and transposition of great arteries (TGA), 3: other obstructive or complex heart diseases, 4: no definitive heart anomaly by postnatal 2D-echocardiography). Then we compared the diseases neonatal outcomes including the status of prenatally detection of congenial heart diseases, diseases category, interval between birth and first operation, and infantile death. 60.2% of neonates were transferred into our institution after birth and 39.8% were born in our hospital. The prenatal detection rate was significantly higher in inborn group (16.5% vs. 83.5%, p < 0.001). Also, there were significant differences in the categories of diseases between two groups. In out-borne group, the rate of septal defects was the highest but, the rate of TOF or TGA was highest in in-born group. However, there was no difference in the rate of surgical correction of heart diseases (76.2% vs. 65.9%, p = 0.069) and the rate of surgical correction within neonatal period (61.6% vs. 67.9%, p = 0.488). In addition, there were 16 mortality case and no differences in mortality rate between two groups (6.8% vs. 8.0%, p = 0.794). In this, we found that more than half of neonates with congenital heart diseases transferred after delivery and we can assume that the cause of this phenomenon is the missing of the prenatal detection of congenital heart diseases. Also, we could observe that TOF and TGA were easily detected in prenatal ultrasonography but septal defects were missed frequently in prenatal screening.