Korean circulation journal · 2026
Neonatal and 18-24-Month Growth and Neurodevelopmental Outcomes in Very Low Birth Weight Infants With Severe Congenital Heart Disease: A Korean Neonatal Network Study.
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Kwak Jung Il, Kim Soo Hyun, Yoo Kyusang, Kim Tae-Gyeong, Park Juhee, Kwak Abraham, Roh Joo Hyung, Lee Jeong Min, Lee Ha Na, Jeong Jiyoon, Kim Chae Young, Jung Euiseok, Lee Byong Sop
Аннотация
BACKGROUND AND OBJECTIVES: Severe congenital heart disease (CHD) in very low birth weight (VLBW) infants poses substantial risks, yet contemporary national data remain limited. This study evaluated the prevalence, lesion spectrum, and neonatal and 18-24-month outcomes of VLBW infants with severe CHD in South Korea.
METHODS: We conducted a nationwide cohort study using the Korean Neonatal Network registry (2013-2021). Severe CHD was defined as a structural defect requiring surgical or catheter-based intervention within the first year of life and was categorized by physiological lesion type. Neonatal mortality, mortality before neonatal intensive care unit (NICU) discharge, major neonatal morbidities, and growth and neurodevelopmental outcomes at 18-24 months' corrected age were compared between infants with and without severe CHD.
RESULTS: Among 15,145 VLBW infants, 147 (1.0%) had severe CHD. Infants with severe CHD had higher neonatal mortality within 28 days (27.2% vs. 9.3%; adjusted odds ratio [OR], 3.37; 95% confidence interval [CI], 2.26-5.04) and mortality before NICU discharge (35.4% vs. 10.6%; adjusted OR, 5.95; 95% CI, 3.94-9.00) than those without severe CHD. Pulmonary hypertension, moderate-to-severe bronchopulmonary dysplasia, and necrotizing enterocolitis (stage ≥2) were more frequent in the severe CHD group. At 18-24 months, severe CHD was associated with higher rates of growth failure and neurodevelopmental impairment (34.1% vs. 20.0%; OR, 2.07, 95% CI, 1.32-3.24).
CONCLUSIONS: Severe CHD occurred in ~1% of VLBW infants and was associated with markedly higher mortality, greater neonatal morbidity, and increased risks of impaired growth and neurodevelopment at 18-24 months' corrected age.
METHODS: We conducted a nationwide cohort study using the Korean Neonatal Network registry (2013-2021). Severe CHD was defined as a structural defect requiring surgical or catheter-based intervention within the first year of life and was categorized by physiological lesion type. Neonatal mortality, mortality before neonatal intensive care unit (NICU) discharge, major neonatal morbidities, and growth and neurodevelopmental outcomes at 18-24 months' corrected age were compared between infants with and without severe CHD.
RESULTS: Among 15,145 VLBW infants, 147 (1.0%) had severe CHD. Infants with severe CHD had higher neonatal mortality within 28 days (27.2% vs. 9.3%; adjusted odds ratio [OR], 3.37; 95% confidence interval [CI], 2.26-5.04) and mortality before NICU discharge (35.4% vs. 10.6%; adjusted OR, 5.95; 95% CI, 3.94-9.00) than those without severe CHD. Pulmonary hypertension, moderate-to-severe bronchopulmonary dysplasia, and necrotizing enterocolitis (stage ≥2) were more frequent in the severe CHD group. At 18-24 months, severe CHD was associated with higher rates of growth failure and neurodevelopmental impairment (34.1% vs. 20.0%; OR, 2.07, 95% CI, 1.32-3.24).
CONCLUSIONS: Severe CHD occurred in ~1% of VLBW infants and was associated with markedly higher mortality, greater neonatal morbidity, and increased risks of impaired growth and neurodevelopment at 18-24 months' corrected age.