Delivery room asphyxia in neonates with ductal-dependent congenital heart disease: a retrospective cohort study.

OBJECTIVE

We aimed to investigate the clinical course and outcome of newborns with ductal-dependent congenital heart disease (CHD) who suffered from perinatal asphyxia.

STUDY

DESIGN

Clinical data of 504 patients with ductal-dependent CHD and perinatal asphyxia were retrospectively analyzed over a 10-year period (2005-2014).

RESULT: Perinatal asphyxia was diagnosed in 17 (3.4%) patients, comprising two nonoverlapping groups: Five infants with intrauterine acidosis (umbilical artery pH < 7.0), and 12 infants with persistent or deteriorating postnatal depression (Apgar score <6 at 10 min of life). Preoperative (41.7%, p < 0.001) and overall mortality (50.0%, p = 0.001) were increased in infants with asphyxia caused by persistent or deteriorating postnatal depression. Apgar scores at 10 min were independently associated with preoperative (OR 0.479, 95% CI 0.342-0.672, p < 0.001) and overall death (OR 0.655, 95% CI 0.537-0.799, p < 0.001).

CONCLUSIONS

Asphyxia caused by postnatally deteriorating depression rather than fetal acidosis is associated with high mortality.