Objective:Neonates with congenital heart disease(CHD)and perinatal stroke have high mortality and survivors are at risk for poor long-term neurodevelopmental outcome.The aim of this study was to assess the risk factor...Objective:Neonates with congenital heart disease(CHD)and perinatal stroke have high mortality and survivors are at risk for poor long-term neurodevelopmental outcome.The aim of this study was to assess the risk factors and outcome of neonates with both CHD and MRI-confirmed perinatal stroke(Study Group)and compare those to the risk factors and outcome of infants matched for CHD without stroke(Control-1)and of infants matched for MRI-confirmed stroke without CHD(Control-2).Methods:We conducted a population-based case-control study enrolling 28 term neonates with CHD and MRI-confirmed acute perinatal stroke born between 2007–2017 in the Central-Hungarian Region.Each of the control groups included 56 infants.The Bayley Scales of Infant Development-II,the Brunet-Lézine test and the Binet Intelligence scales-V were used for neurodevelopmental follow-up at a median age of 61 months.Results:Mortality was highest in the Study Group(25%compared to 5%and 2%,respectively,p=0.001).Adverse neurodevelopmental outcome was prevalent in the Study(53%)and Control-2 Groups(52%,p=0.03).Significantly different parameters among the three groups included Apgar scores,mode of delivery,gestational age at birth,cardiac interventions and twin pregnancy.In a multivariable regression analysis adjusted for clinically relevant parameters,patients in the Study Group had significantly higher odds for mortality compared to patients in the Control-1 Group(OR:6.595%CI:1.1–39.4).Conclusions:Neonates with perinatal stroke and CHD are at a higher risk for dying compared to neonates with CHD without stroke.In addition,the stroke-associated direct insult to the brain likely plays an important role in the development of neurodevelopmental morbidity in these patients.展开更多
基金Financial support for this work(E.V.)was provided by the New National Excellence Program of the Ministry for Innovation and Technology from the Source of the National Research,Development and Innovation Fund(ÚNKP-21–3-II-SE-5)(www.unkp.hu)by the Semmelweis University(EFOP-3.6.3.-VEKOP-16–2017–00009)(https://semmelweis.hu/phd/2021/11/09/).
文摘Objective:Neonates with congenital heart disease(CHD)and perinatal stroke have high mortality and survivors are at risk for poor long-term neurodevelopmental outcome.The aim of this study was to assess the risk factors and outcome of neonates with both CHD and MRI-confirmed perinatal stroke(Study Group)and compare those to the risk factors and outcome of infants matched for CHD without stroke(Control-1)and of infants matched for MRI-confirmed stroke without CHD(Control-2).Methods:We conducted a population-based case-control study enrolling 28 term neonates with CHD and MRI-confirmed acute perinatal stroke born between 2007–2017 in the Central-Hungarian Region.Each of the control groups included 56 infants.The Bayley Scales of Infant Development-II,the Brunet-Lézine test and the Binet Intelligence scales-V were used for neurodevelopmental follow-up at a median age of 61 months.Results:Mortality was highest in the Study Group(25%compared to 5%and 2%,respectively,p=0.001).Adverse neurodevelopmental outcome was prevalent in the Study(53%)and Control-2 Groups(52%,p=0.03).Significantly different parameters among the three groups included Apgar scores,mode of delivery,gestational age at birth,cardiac interventions and twin pregnancy.In a multivariable regression analysis adjusted for clinically relevant parameters,patients in the Study Group had significantly higher odds for mortality compared to patients in the Control-1 Group(OR:6.595%CI:1.1–39.4).Conclusions:Neonates with perinatal stroke and CHD are at a higher risk for dying compared to neonates with CHD without stroke.In addition,the stroke-associated direct insult to the brain likely plays an important role in the development of neurodevelopmental morbidity in these patients.
