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Pediatrics. 2013 Jul;132(1):49-61. doi: 10.1542/peds.2012-3111. Epub 2013 Jun 3.

Ten-year review of major birth defects in VLBW infants.

Collaborators (253)

Caplan MS, Oh W, Vohr BR, Alksninis B, Stephens BE, Yatchmink Y, Burke R, Hensman AM, Leach TM, Leonard MR, Noel L, Vogt RA, Watson VE, Ventura S, Fanaroff AA, Wilson-Costello DE, Siner BS, Friedman HG, Schibler K, Donovan EF, Steichen JJ, Yolton K, Alexander B, Bridges K, Grisby C, Mersmann MW, Mincey HL, Hessling J, Gratton TL, Goldberg RN, Cotten C, Auten KJ, Fisher KA, Foy KA, Gustafson KE, Lohmeyer MB, Carlton DP, Carter S, Dinkins E, LaRossa MM, Smikle GV, Wright LL, McClure EM, Archer SW, Poindexter BB, Lemons JA, Dusick AM, Lytle C, Bohnke LG, Eaken G, Herron D, Miller LC, Minnich HM, Richard L, Wilson LD, Hamer F, Poole WK, Wallace D, Newman JE, Auman JO, Cunningham M, Hastings BK, McClure EM, Huitema C, Zaterka-Baxter KM, Stevenson DK, Hintz SR, Epi MS, Adams MM, Ahlfors CE, Baran JM, Bentley B, Bond LE, Brudos GK, Davis AS, DeAnda ME, DeBattista AM, Epcar JT, Fleisher BE, Ismael M, Kohn JG, Kuelper CG, Lee-Ancajas JC, Proud MS, Pyle RP, Sivakumar D, Stebbins RD, St John NH, Frantz III I, McGowan EC, MacKinnon BL, Nylen E, Furey A, Sibley C, Brussa A, Ambalavanan N, Peralta-Carcelen M, Nelson KG, Bailey KJ, Biasini FJ, Chopko SA, Collins MV, Cosby SS, Moses MB, Phillips VA, Preskitt J, Rector RV, Whitley S, Finer NN, Vaucher YE, Rasmussen MR, Wozniak PR, Arnell K, Bridge R, Demetrio C, Fuller MG, Posin D, Rich W, Widness JA, Colaizy TT, Johnson KJ, Eastman DL, Bauer CR, Duara S, Everett-Thomas R, Worth AM, Allison M, Diaz AN, Mathews EO, Hamlin-Smith K, Jean-Gilles L, Calejo M, Eguaras SM, Hiriart-Fajardo S, Gideon YC, Berkovits M, Stoerger A, Garcia A, Pierre H, Watterberg KL, Papile LA, Ohls RK, Lacy CB, Lowe JR, Montman R, Phelps DL, Guillet R, Myers GJ, Reubens LJ, Burnell E, Rowan M, Horihan CA, Johnson JB, Hust D, Jensen RL, Kushner E, Merzbach J, Zwetsch L, Yost K, Korones SB, Bada HS, Hudson T, Williams M, Yolton K, Rosenfeld CR, Salhab WA, Broyles R, Heyne RJ, Adams SS, Boatman CT, Burchfield J, Dooley C, Guzman A, Heyne E, Hickman JF, Leps MH, Madden LA, Miller NA, Morgan JS, Madison S, Hensley G, Vasil DM, Torres LE, Tyson JE, Kennedy KA, Akpa EG, Cluff PA, Harris BF, Franco CI, Lis AE, Martin S, McDavid GE, Tate PL, Simmons MC, Evans PW, Alaniz NI, Bradt PJ, Cedillo M, Dieterich S, Green C, Jiminez M, Major-Kincade T, Morris BH, Poundstone M, Reddoch S, Siddiki S, Whitely LL, Wright SL, Faix RG, Yoder BA, Bodnar A, Steffens M, Baker S, Burnett J, Jensen JJ, Osborne KA, Weaver-Lewis K, O'Shea T, Dillard RG, Peters NJ, Chiu K, Allred DE, Goldstein DJ, Halfond R, Jackson BG, Peterson C, Waldrep EL, Morris MW, Hounshell GW, Johnson YR, Pappas A, Bara R, Driscoll D, Goldston L, Kennedy D, Muran G, Billian E, Sumner L, Sawaya K, Weingarden K, Ehrenkranz RA, Butler C, Jacobs H, Cervone P, Close N, Gettner P, Gilliam W, Greisman S, Konstantino M, Poulsen J, Romano E, Taft J, Williams J.

Author information

1
Department of Pediatrics, Emory University School of Medicine, and Children’s Healthcare of Atlanta, Atlanta, GA, USA. iadamsc@emory.edu

Abstract

OBJECTIVE:

Birth defects (BDs) are an important cause of infant mortality and disproportionately occur among low birth weight infants. We determined the prevalence of BDs in a cohort of very low birth weight (VLBW) infants cared for at the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers over a 10-year period and examined the relationship between anomalies, neonatal outcomes, and surgical care.

METHODS:

Infant and maternal data were collected prospectively for infants weighing 401 to 1500 g at NRN sites between January 1, 1998, and December 31, 2007. Poisson regression models were used to compare risk of outcomes for infants with versus without BDs while adjusting for gestational age and other characteristics.

RESULTS:

A BD was present in 1776 (4.8%) of the 37 262 infants in our VLBW cohort. Yearly prevalence of BDs increased from 4.0% of infants born in 1998 to 5.6% in 2007, P < .001. Mean gestational age overall was 28 weeks, and mean birth weight was 1007 g. Infants with BDs were more mature but more likely to be small for gestational age compared with infants without BDs. Chromosomal and cardiovascular anomalies were most frequent with each occurring in 20% of affected infants. Mortality was higher among infants with BDs (49% vs 18%; adjusted relative risk: 3.66 [95% confidence interval: 3.41-3.92]; P < .001) and varied by diagnosis. Among those surviving >3 days, more infants with BDs underwent major surgery (48% vs 13%, P < .001).

CONCLUSIONS:

Prevalence of BDs increased during the 10 years studied. BDs remain an important cause of neonatal morbidity and mortality among VLBW infants.

KEYWORDS:

Neonatal Research Network; birth defects; low birth weight; prematurity

PMID:
23733791
PMCID:
PMC3691532
DOI:
10.1542/peds.2012-3111
[Indexed for MEDLINE]
Free PMC Article

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