Neonatal Med.  2018 Nov;25(4):137-143. 10.5385/nm.2018.25.4.137.

Clinical Features of Critical Congenital Heart Disease in Term Infants with Hypoxemia: A Single-Center Study in Korea

• Choi EK
• Shin JH
• Jang GY
• Choi BM

• KMID: 2436131
• DOI: http://doi.org/10.5385/nm.2018.25.4.137

Abstract

PURPOSE
This study was performed to determine the clinical features of full-term infants with hypoxemia detected by pulse oximetry and to establish the diagnosis of critical congenital heart disease (CCHD).
METHODS
We retrospectively reviewed the medical records of neonates who had been admitted to the neonatal intensive care unit within 2 weeks of birth at Korea University Ansan Hospital between January 2013 and October 2017 (n=450). We classified these neonates based on the presence of hypoxemia at admission and investigated neonatal characteristics, initial symptoms, echocardiographic findings, and final diagnosis associated with hypoxemic diseases.
RESULTS
Of 450 term infants, 265 infants (58.9%) were identified hypoxemia by pulse oximetry at admission. The most common symptoms of them were cyanosis and tachypnea. Among them, 80.1% of infants (214/265) were diagnosed with respiratory tract disease and 8.3% of infants (22/265) had congenital heart disease. Thirteen infants (13/265, 4.9%) had CCHD and were treated with urgent surgery or transcatheter intervention within 28 days of birth. Majority of infants with respiratory tract disorder were transferred from hospital immediately after birth, but 46.1% of infants (6/13) with CCHD remained asymptomatic after birth and were admitted after 48 hours after birth. In addition, other hypoxemic illnesses were identified as neonatal infectious and neurological diseases.
CONCLUSION
This study showed the importance of assessment in neonates with hypoxemia, including those diagnosed with CCHD. The possibility of CCHD should be considered in the differential diagnosis in neonates demonstrating hypoxemia after 48 hours of birth. A larger prospective study is needed to assess the effectiveness and outcomes of pulse oximetry for neonatal screening in Korea.

Keyword

Hypoxemia; Congenital heart disease; Oximetry; Newborn

MeSH Terms

Anoxia*
Cyanosis
Diagnosis
Diagnosis, Differential
Echocardiography
Gyeonggi-do
Heart Defects, Congenital*
Humans
Infant*
Infant, Newborn
Intensive Care, Neonatal
Korea*
Medical Records
Neonatal Screening
Oximetry
Parturition
Prospective Studies
Respiratory System
Respiratory Tract Diseases
Retrospective Studies
Tachypnea

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