Outcomes of congenital heart disease in late preterm infants: double jeopardy?

Aim:  To evaluate outcomes of late preterm (34–36 6/7 weeks gestation) infants with congenital heart defects requiring surgical intervention during initial admission (added), in comparison with term (37–42 weeks) controls. Methods:  This was a retrospective chart review of consecutive late preterm and term infants with congenital heart lesions, requiring surgical intervention during initial admission. Results:  Our cohort (n = 88) comprised 26 late preterm infants (group 1) and 62 term controls (group 2). The two groups differed significantly in mean (SD) gestation [34.5 (1.5) vs. 39.1 (1) weeks)], birth weight [2335 (402) vs. 3173 (401) g] and weight [2602 (739) vs. 3273 (507) g] and age [33 (51) vs. 11 (14) days] at surgery. Cardiac diagnosis frequencies were similar in both groups. The mean (SD) duration of PGE1 [31.9 (56.8) vs. 11.3 (24.9) days] and need for preoperative pressors (25% vs. 8%) were significantly higher in group 1. Death (23% vs. 8%, p = 0.05) tended to be higher in group 1. Rates of necrotizing enterocolitis (23% vs. 1.7%), seizures (19% vs. 0%), oxygen need (12% vs. 0%) and gavage feeds (12% vs. 1.6%) at discharge were all significantly higher in the late preterm cohort. Conclusions:  These data highlight the extreme vulnerability of infants with the ‘double hits’ of prematurity and heart defects.