Research Article
Volume 11 Issue 2 - 2022
Risk Factors for Mortality in Neonates with a Congenital Heart Disease; A Systematic Review and Meta-Analysis
Muhammad Ali*, Aesha Mohammedi and Mohamed Hamooda
Consultant Neonatologist, Leicester, England, United Kingdom
*Corresponding Author: Muhammad Ali, Consultant Neonatologist, Leicester, England, United Kingdom.
Received: January 05, 2022; Published: January 31, 2022




Abstract

Background: Congenital heart diseases (CHDs) are cardiovascular malformations related to atypical cardio-vascular development. The morbidity, mortality, and long-term outcomes of CHDs depend on the proper identification of neonates at a higher risk of death.

Objectives: This meta-analysis was conducted to reveal the potential pre-natal, peri-natal, and post-natal predictors of mortality among neonates with congenital heart diseases.

Methods: An extensive systematic literature review was performed until 28th August 2020. All clinical studies comparing the perinatal characteristics of survivors and non-survivors in neonates with CHDs were included. Studies reporting the potential predictors of mortality in neonates with CHDs were also included.

Results: This meta-analysis included 16 retrospective studies including 39232 neonates with CHDs. Patients were furtherly assorted into survivors and non-survivors groups, accounting for 29353 (78.65%) and 7967 (21.34%), respectively. The neonatal mortality rate was 23.7% (95CI%23.2% to 24.2%, p < 0.001) during the neonatal period. Caesarian deliveries (RR1.20; 95% 1.01, 1.44; P = 0.04), prematurity (RR4.38; 95%1.56, 12.32; P = 0.005), gestational age (20 - 31 weeks) (RR 3.96; 95%1.38, 11.39; P = 0.01), surgeons experience < 5 years (RR1.2; 95%1.09, 1.32; P = 0.0002) and cardiopulmonary bypass time (Mean Difference: MD-29.15 minutes; 95%-36.49, -21.80; P < 0.001) were statistically significant predictors of neonatal death from CHDs.

Conclusion: The risk factors for mortality in neonates with CHDs are prematurity, deliveries by caesarian delivery, low birth weight and neonatal necrotizing enterocolitis. Neonates with preoperative mechanical ventilation, prolonged cardiopulmonary bypass time, surgeries performed by less experienced surgeons, post-operative complications including acute kidney injury, thrombosis, or stroke after cardiac interventions were more likely to die from CHDs during the neonatal period.

 

Keywords: Neonatal; Mortality; Congenital Heart Diseases

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Citation: Muhammad Ali., et al. “Risk Factors for Mortality in Neonates with a Congenital Heart Disease; A Systematic Review and Meta-Analysis”. EC Paediatrics 11.2 (2022): 85-102.

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