Screening of high risk neonates for congenital heart defects: A study in level III neonatal intensive care unit

Abstract

Introduction: Congenital heart defects are most common birth defects representing a major global health problem. So, early screening of high risk newborns for congenital heart defects is essential foe early intervention thereby help us to reduce morbidity and mortality. It is very important to screen all high-risk newborn for congenital heart defects, early identification and management to reduce mortality and morbidity in tertiary care neonatal intensive care unit. Pattern of CHDs is essential to predict management and outcome.

Methods and Materials: A one year prospective study was carried out in a level III neonatal intensive care, Department of pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India, from October 2015 to September 2016. All high-risk newborns were screened for congenital heart defects through transthoracic 2D echocardiography. Patent foramen ovale in preterm was excluded. Retrospectively maternal risk factors were studied.

Results: Total live births during the study period were 15127. And total admissions to our neonatal intensive care were 4531 cases. High-risk newborns screened for congenital heart defects are 1324 cases during the study period. Among 1324 newborns screened, 645 cases (49%) were having CHDs, 679(51%) were normal. Among CHDs 326 babies had ASD, 102 babies had VSD, 223 cases had PDA, and 35 cases had cyanotic congenital heart defects.

Conclusions: Nearly half of the high risk newborns had CHD, thus it’s very essential to screen them at the earliest. Majority of CHDs were cyanotic type of CHDs. Preterm babies, babies born to diabetic mothers and babies who had severe respiratory distress requiring prolonged ventilator support are highly prone for having underlying CHDs. Babies born to mothers who had antenatal folic acid supplementations were less likely to have CHDs.