Prevalence and Infant Mortality of Major Congenital Malformations Stratified by Birthweight

Neonatology ◽  
2021 ◽  
pp. 1-19
Author(s):  
Janine Kröger ◽  
Christian Günster ◽  
Günther Heller ◽  
Elke Jeschke ◽  
Jürgen Malzahn ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Congenital Malformations ◽  
Low Birthweight ◽  
Survival Rates ◽  
Very Low Birthweight ◽  
Life Threatening ◽  
Major Congenital Malformations ◽  
Public Health Insurance System ◽  
Severe Congenital Heart Disease ◽  
The Impact

<b><i>Background:</i></b> Low birthweight and major congenital malformations (MCMs) are key causes of infant mortality. <b><i>Objectives:</i></b> The aim of this study was to explore the prevalence of MCMs in infants with low and very low birthweight and analyze the impact of MCMs and birthweight on infant mortality. <b><i>Methods:</i></b> We determined prevalence and infant mortality of 28 life-threatening MCMs in very-low-birthweight (&#x3c;1,500 g, VLBW), low-birthweight (1,500–2,499 g, LBW), or normal-birthweight (≥2,500 g, NBW) infants in a cohort of 2,727,002 infants born in Germany in 2006–2017, using de-identified administrative data of the largest statutory public health insurance system in Germany. <b><i>Results:</i></b> The rates of VLBW, LBW, and NBW infants studied were 1.3% (34,401), 4.0% (109,558), and 94.7% (2,583,043). MCMs affected 0.5% (13,563) infants, of whom &#x3e;75% (10,316) had severe congenital heart disease. The prevalence (per 10,000) of any/cardiac MCM was increased in VLBW (286/176) and LBW (244/143), as compared to NBW infants (38/32). Infant mortality rates were significantly higher in infants with an MCM, as opposed to infants without an MCM, in each birthweight group (VLBW 28.5% vs. 11.5%, LBW 16.7% vs. 0.9%, and NBW 8.6% vs. 0.1%). For most MCMs, observed survival rates in VLBW and LBW infants were lower than expected, as calculated from survival rates of VLBW or LBW infants without an MCM, and NBW infants with an MCM. <b><i>Conclusions:</i></b> Infants with an MCM are more often born with LBW or VLBW, as opposed to infants without an MCM. Many MCMs carry significant excess mortality when occurring in VLBW or LBW infants.

scholarly journals Mucormycosis: An Uncommon Cutaneous Infection at Permanent Pacemaker-Implanted Site in a Very Low-Birthweight Baby

2022 ◽  
Author(s):  
Minati Choudhury ◽  
Jitin Narula ◽  
Milind P. Hote ◽  
Sarita Mohapatra
Keyword(s):  
Heart Block ◽  
Low Birthweight ◽  
Pulse Generator ◽  
Complete Heart Block ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Cutaneous Infection ◽  
Very Low Birthweight ◽  
Congenital Complete Heart Block ◽  
Life Threatening

AbstractPermanent pacemaker implantation in low birthweight (LBW) babies with congenital complete heart block is extremely challenging due to a paucity of appropriate pulse generator placement pocket sites. The development of infection following an implantation procedure can pose a life-threatening risk to the patients. With more patients in the younger group receiving these devices than ever before and the rate of infection increasing rapidly, a closer look at the burden of infection and its impact on outcome of these patients is warranted. We report mucormycosis infection at the abdominal pacemaker pocket site of an infant requiring pacemaker explantation and re-insertion into the intrapleural space.

Levetiracetam Pregnancy Registry: Final results and a review of the impact of registry methodology and definitions on the prevalence of major congenital malformations

2019 ◽  
Vol 111 (13) ◽  
pp. 872-887 ◽  
Author(s):  
Angela E. Scheuerle ◽  
Lewis B. Holmes ◽  
Jessica D. Albano ◽  
Vincent Badalamenti ◽  
Dina Battino ◽  
...  
Keyword(s):  
Congenital Malformations ◽  
Major Congenital Malformations ◽  
The Impact ◽  
Pregnancy Registry

scholarly journals Birth outcomes following antiretroviral exposure during pregnancy: Initial results from a pregnancy exposure registry in South Africa

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ushma C. Mehta ◽  
Cari Van Schalkwyk ◽  
Prineetha Naidoo ◽  
Arthi Ramkissoon ◽  
Otty Mhlongo ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Congenital Malformations ◽  
First Trimester ◽  
First Year ◽  
Increased Risk ◽  
Bivariable Analysis ◽  
Major Congenital Malformations ◽  
Clinical Records ◽  
Surface Examination ◽  
The Impact

Background: In 2013, a pregnancy exposure registry and birth defects surveillance (PER/BDS) system was initiated in eThekwini District, KwaZulu-Natal (KZN), to assess the impact of antiretroviral treatment (ART) on birth outcomes.Objectives: At the end of the first year, we assessed the risk of major congenital malformations (CM) and other adverse birth outcomes (ABOs) detected at birth, in children born to women exposed to ART during pregnancy.Method: Data were collected from women who delivered at Prince Mshiyeni Memorial Hospital, Durban, from 07 October 2013 to 06 October 2014, using medicine exposure histories and birth outcomes from maternal interviews, clinical records and neonatal surface examination. Singleton births exposed to only one ART regimen were included in bivariable analysis for CM risk and multivariate risk analysis for ABO risk.Results: Data were collected from 10 417 women with 10 517 birth outcomes (4013 [38.5%] HIV-infected). Congenital malformations rates in births exposed to Efavirenz during the first trimester (T1) (RR 0.87 [95% CI 0.12–6.4; p = 0.895]) were similar to births not exposed to ART during T1. However, T1 exposure to Nevirapine was associated with the increased risk of CM (RR 9.28 [95% CI 2.3–37.9; p = 0.002]) when compared to the same group. Other ABOs were more frequent in the combination of HIV/ART-exposed births compared to HIV-unexposed births (29.9% vs. 26.0%, adjusted RR 1.23 [1.14–1.31; p 0.001]).Conclusion: No association between T1 use of EFV-based ART regimens and CM was observed. Associations between T1 NVP-based ART regimen and CM need further investigation. HIV- and ART-exposed infants had more ABOs compared to HIV-unexposed infants.

scholarly journals Safety of Cow’s Milk-Derived Fortifiers Used with an All-Human Milk Base Diet in Very Low Birthweight Preterm Infants

2020 ◽  
Vol 15 (7) ◽  
pp. 3-13
Author(s):  
Alan Lucas ◽  
Maushumi Assad ◽  
Jan Sherman ◽  
John Boscardin ◽  
Steven Abrams
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Low Birthweight ◽  
Ductus Arteriosus ◽  
Cow’S Milk ◽  
Very Low Birthweight ◽  
Cow's Milk ◽  
Increased Risk ◽  
Preterm Formula ◽  
The Impact

Background: Very low birthweight (VLBW) preterm infants fed mothers own milk (MOM) need nutritional supplementation, traditionally achieved with cow’s milk derived fortifier (CMDF) and preterm formula (PTF) if MOM is insufficient. CM products have been associated with diverse major morbidities. The current recommendation is to preferentially replace PTF with donor milk (DM) to produce a 100% human milk (HM) base diet, usually fortified with CMDF. Objective: To identify whether CMDF, even when fed with a 100% HM base diet, is related to an increased risk of major morbidities. Methods: We identified a randomized trial with an all-HM base diet, comparing CMDF with a fortifier derived from human milk (HMDF), and two additional studies of this design were generated from raw data as subgroup analyses of a randomized controlled trial and a quasi-experimental study. Using these studies, we calculated the impact of CMDF on major morbidities of death, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), sepsis, bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Results: Each study individually provided support for an increase in major morbidities with CMDF. Meta-analyses of pooled data showed that compared to HMDF, the CMDF group had large in- creases in NEC (RR = 3.3; P = .001), ROP (RR = 2.2; P = .007), PDA (RR = 1.6; P = .009), interruption of feeding (RR = 3.4; P = .001) and a positive mortality/morbidity index based on one or more of death, NEC, sepsis, ROP and BPD (RR = 1.4; P = .006). Conclusions: Despite the increased use of HM in modern neonatal care as a base diet, we found a greater risk of critical morbidities with CMDF compared with HMDF. This burden of morbidity provides evidence that the benefits of an HM base diet, might be, in part, counteracted by multiple adverse outcomes relating to the use of CMDF.

Impact of Very Low Birthweight on the Black-White Infant Mortality Gap

1992 ◽  
Vol 8 (5) ◽  
pp. 271-277 ◽  
Author(s):  
Solomon Iyasu ◽  
Jose E. Becerra ◽  
Diane L. Rowley ◽  
Carol J.R. Hogue
Keyword(s):  
Infant Mortality ◽  
Low Birthweight ◽  
Very Low Birthweight

scholarly journals Genetics of diaphragmatic hernia

2021 ◽  
Author(s):  
Yannick Schreiner ◽  
Thomas Schaible ◽  
Neysan Rafat
Keyword(s):  
Pulmonary Hypertension ◽  
Clinical Outcome ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Congenital Malformations ◽  
Lung Hypoplasia ◽  
Complex Phenotype ◽  
Life Threatening ◽  
Major Congenital Malformations ◽  
Very High

AbstractCongenital diaphragmatic hernia (CDH) is a life-threatening malformation characterised by failure of diaphragmatic development with lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). The incidence is 1:2000 corresponding to 8% of all major congenital malformations. Morbidity and mortality in affected newborns are very high and at present, there is no precise prenatal or early postnatal prognostication parameter to predict clinical outcome in CDH patients. Most cases occur sporadically, however, genetic causes have long been discussed to explain a proportion of cases. These range from aneuploidy to complex chromosomal aberrations and specific mutations often causing a complex phenotype exhibiting multiple malformations along with CDH. This review summarises the genetic variations which have been observed in syndromic and isolated cases of congenital diaphragmatic hernia.

Explaining the 2001–2002 Infant Mortality Increase in the United States: Data from the Linked Birth/Infant Death Data Set

2005 ◽  
Vol 35 (3) ◽  
pp. 415-442 ◽  
Author(s):  
Marian F. MacDorman ◽  
Joyce A. Martin ◽  
T. J. Mathews ◽  
Donna L. Hoyert ◽  
Stephanie J. Ventura
Keyword(s):  
Infant Mortality ◽  
Low Birthweight ◽  
The United States ◽  
Infant Mortality Rate ◽  
Very Low Birthweight ◽  
Data Set ◽  
Very Preterm Infants ◽  
Mortality Increase ◽  
Very Low Birthweight Infants ◽  
First Year Of Life

The U.S. infant mortality rate (IMR) increased from 6.8 infant deaths per 1,000 live births in 2001 to 7.0 in 2002, the first increase in more than 40 years. From 2001 to 2002, IMR increased for very low birthweight infants as well as for preterm and very preterm infants. Although IMR for very low birthweight infants increased, most of the increase in IMR from 2001 to 2002 was due to a change in the distribution of births by birthweight and, more specifically, to an increase in infants born weighing less than 750 grams. The majority of infants born at less than 750 grams die within the first year of life; thus, these births contribute disproportionately to overall IMR. Increases in births at less than 750 grams occurred for non-Hispanic white, non-Hispanic black, and Hispanic women. Most of the increase occurred among mothers 20 to 34 years of age. Although multiple births contributed disproportionately, most of the increase in births at less than 750 grams occurred among singletons. Three hypotheses were evaluated to assess their possible impact on the increase in less than 750-gram births: possible changes in (1) the reporting of births or fetal deaths, (2) the risk profile of births, and (3) medical management of pregnancy. Although each of these factors may have contributed to the increase, the relative effects of these and other factors remain unclear. More detailed studies are needed to further explain the 2001–2002 infant mortality increase.

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