Abstract
Congenital heart disease (CHD) is a major health concern worldwide. This study focused on survival analysis and the factors influencing survival in infants with critical congenital heart disease (CCHD). A total of 79 infants diagnosed with CCHD were identified, with 48.1% (n=38) exhibiting duct-dependent pulmonary circulation, 35.6% (n=28) exhibiting duct-dependent systemic circulation, 6.3% (n=5) exhibiting critical non-duct-dependent, and 10.2% (n=8) exhibiting parallel circulation issues. Of the infants studied, 55.7% (n=44) were male, 78.5% (n=62) had a gestational age of ≥37 weeks, 62% (n=49) had a birth weight of ≥2,500 grams, 59.5% (n=47) exhibited normal fetal growth, 93.7% (n=74) experienced no asphyxia, 91.1% (n=72) had no other congenital disabilities, 87.3% (n=69) had no history of fetal distress, 58.2% (n=46) maintained normal oxygen saturation, and 88.6% (n=70) had an extended stay in the neonatal intensive care unit. The survival analysis indicated that the prognosis of newborns with CCHD was markedly affected by gestational age, birth weight, desaturation, respiratory distress, and hereditary abnormalities. Additional study is required to assess the risk factors influencing the survival of newborns with CCHD.
References
1. World Health Organization. Newborn mortality. Geneva: World Health Organization; 2024.
2. World Health Organization. Congenital disorders. Geneva: World Health Organization; 2023.
3. Bergman JEH, Perraud A, Barišić I, et al. Updated EUROCAT guidelines for classification of cases with congenital anomalies. Birth Defect Res.2024; 116 (2): e2314. DOI: 10.1002/bdr2.2314.
4. Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: Summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323 (13): 1239–1242. DOI:10.1001/jama.2020.2648.
5. Hwang IC, Sisavanh M, Billamay S, et al. Congenital heart disease at Laos Children’s Hospital: Two-year experience. Pediatr Int. 2017; 59 (3): 271–279. DOI: 10.1111/ped.13156.
6. Bravo-Valenzuela NJ, Peixoto AB, Araujo Júnior E. Prenatal diagnosis of congenital heart disease: A review of current knowledge. Indian Heart J. 2018; 70 (1): 150-164. DOI: 10.1016/j.ihj.2017.12.005.
7. Bakker MK, Bergman JEH, Krikov S, et al. Prenatal diagnosis and prevalence of critical congenital heart defects: An international retrospective cohort study. BMJ Open. 2019; 9 (7): e028139. DOI: 10.1136/bmjopen-2018-028139.
8. Çaylan N, Yalçın SS, Tezel B, et al. Evaluation of critical congenital heart disease from 2018 to 2020 in Turkey: A retrospective cohort study. BMC Pregnancy Childbirth. 2023; 23: 871. DOI: 10.1186/s12884-023-06193-1.
9. Kaneda T, Greenbaum C, Haub C. World population data sheet 2021. Washington, DC: Population Reference Bureau; 2021.
10. Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: Updated systematic review and meta-analysis of260 studies. Int J Epidemiol. 2019; 48 (2): 455-463. DOI: 10.1093/ije/dyz009.
11. Zhang W, Xu HY, Zhang YC, et al. Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: A retrospective study. J Int Med Res. 2021; 49 (7): 1–10. DOI: 10.1177/03000605211028028.
12. Lopes SAVDA, Guimarães ICB, Costa SF de O, et al. Mortality for critical congenital heart diseases and associated risk factors in newborns: Acohort study. Arq Bras Cardiol. 2018; 111 (5): 666-673. DOI: 10.5935/abc.20180175.
13. Çaylan N, Yalçın SS, Tezel B, et al. Investigation of infant deaths associated with critical congenital heart diseases: 2018–2021, Türkiye. BMCPublic Health. 2024; 24: 441. DOI: 10.1186/s12889-024-17966-4.
14. Mat Bah MN, Sapian MH, Jamil MT, et al. Survival and associated risk factors for mortality among infants with critical congenital heart disease in a developing country. Pediatr Cardiol. 2018; 39 (7): 1389–1396. DOI: 10.1007/s00246-018-1908-6.
15. Meyer SL, Wolff D, Ridderbos FJS, et al. Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation. Int J Cardiol Congenit Hear Dis. 2021; 5: 100197. DOI: 10.1016/J.IJCCHD.2021.100197.
16. Cheung PY, Hajihosseini M, Dinu IA, et al. Outcomes of Preterm Infants with Congenital Heart Defects After Early Surgery: Defining Risk Factors at Different Time Points During Hospitalization. Front Pediatr. 2021; 8: 616659. DOI: 10.3389/FPED.2020.616659.
17. Benjamin RH, Nguyen JM, Canfield MA, et al. Survival of neonates, infants, and children with birth defects: A population-based study in Texas, 1999–2018. Lancet Reg Heal - Am. 2023; 27: 100617. DOI: 10.1016/J.LANA.2023.100617.
18. Gimeno L, Brown K, Harron K, et al. Trends in survival of children with severe congenital heart defects by gestational age at birth: A population‐based study using administrative hospital data for England. Paediatr Perinat Epidemiol. 2023; 37 (5): 390. DOI: 10.1111/PPE.12959.
19. Levine J, Mayer JE, Pulmonary Atresia With Intact Ventricular Septum. In: Walsh EP, Teele SA, Mayer JE, Brown DW, editors. Nadas’ Pediatr Cardiol. 3rd ed. Elsevier; 2025. p. 471-477. DOI: 10.1016/B978-1-4557-0599-3.00046-6
20. Kritzmire SM, Cossu AE. Hypoplastic left heart syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
21. Steurer MA, Peyvandi S, Baer RJ, et al. Impaired fetal environment and gestational age: What is driving mortality in neonates with criticalcongenital heart disease? JAHA J Am Heart Assoc. 2019; 8 (22): e013194.
22. Azhar AS, Al Shammasi ZH, Higgi RE. The impact of congenital heart diseases on the quality of life of patients and their families in Saudi Arabia: Biological, psychological, and social dimensions. Saudi Med J. 2016; 37 (4): 392–398. DOI: 10.15537/smj.2016.4.13626.
23. Zych-Krekora K, Sylwestrzak O, Grzesiak M, et al. Impact of prenatal and postnatal diagnosis on parents: Psychosocial and economic aspectsrelated to congenital heart defects in children. J Clin Med. 2023; 12 (18): 5773. DOI: 10.3390/jcm12185773.
24. Sprong MCA, Zwagerman IR, Soeters L, et al. Prioritizing family-centered developmental care: Insights from parents of children with criticalcongenital heart disease: A qualitative study. Eur J Pediatr. 2024; 183 (9): 3863-3876. DOI: 10.1007/s00431-024-05600-9.
25. Centers for Disease Control and Prevention. Living with a congenital heart defect | Congenital heart defects (CHDs). Atlanta, GA: Centers forDisease Control and Prevention; 2024.
26. Marelli A, Miller SP, Marino BS, et al. Brain in congenital heart disease across the lifespan: The cumulative burden of injury. Circulation. 2016;133 (20): 1951–1962. DOI: 10.1161/CIRCULATIONAHA.115.019881.
27. Lisanti AJ. Parental stress and resilience in congenital heart disease: A new frontier for health disparities research. Cardiol Young. 2018; 28 (9): 1142-1150. DOI: 10.1017/S1047951118000963.
28. Grosse SD, Peterson C, Abouk R, et al. Cost and cost-effectiveness assessments of newborn screening for critical congenital heart disease using pulse oximetry: A review. Int J Neonatal Screen. 2017; 3 (4): 34. DOI: 10.3390/ijns3040034.
29. Chamorro Velásquez CL, Sandoval Reyes NF, Taborda Restrepo A, et al. The economic impact of critical congenital heart disease to the healthsystem and families in Colombia. F1000Res. 2019; 8: 92. DOI: https://f1000research.com/articles/8-92/v1.
30. Su Z, Zou Z, Hay SI, et al. Global, regional, and national time trends in mortality for congenital heart disease, 1990–2019: An age-period-cohort analysis for the Global Burden of Disease 2019 study. EClinicalMedicine. 2022; 43: 101249. DOI: 10.1016/j.eclinm.2021.101249.
31. Bai Z, Han J, An J, et al. The global, regional, and national patterns of change in the burden of congenital birth defects, 1990–2021: An analysis of the Global Burden of Disease Study 2021 and forecast to 2040. EClinicalMedicine. 2024; 77: 102873. DOI: 10.1016/j.eclinm.2024.102873.
Recommended Citation
Talib SR , Siswanto JE , Djer MM ,
et al.
Characteristic and Survival Analysis of Infants with Critical Congenital Heart Disease.
Kesmas.
2025;
20(1):
8-14
DOI: 10.7454/kesmas.v20i1.2041
Available at:
https://scholarhub.ui.ac.id/kesmas/vol20/iss1/2