Clinical Features Of Congenital Heart Disease In Hospitalized Neonates

Objective: To understand clinical features of congenital heart disease (CHD) in hospitalized neonates in the past 6 years.Methods: Clinical data of 1576 neonates with CHD who were treated in Children's Hospital of Chongqing Medical University neonatal ward in the past 6 years from January 2005 to December 2010 was collected and the gender, age, discharge diagnosis, clinical manifestations, complications, associated extracardiac malformation,chest X-ray and cardiac doppler echocardiography (cardiac ultrasound) were recorded.All cases were divided into two types,non-cyanotic CHD and cyanotic CHD. The above indicators of the two types of CHD were respectivly analyzed retrospectively.All the numberation data was expressed by the count of cases and percentage, and analysis by chi-square test.Results: (1)The proportion of CHD in spectrum of disease in hospitalized neonates was 5.34% (1576/29540) in this group.(2)Non-cyanotic CHD (1315 cases) is more common than cyanotic CHD(261 cases).PDA (34.4%, 452/1315) is the most commonly CHD in the type of non-cyanotic CHD, followed by complex malformations (24.2%, 319/1315).In the type of cyannotic CHD,complete transposition of great arteries is the most commonly CHD in cyanotic CHD, followed by of tetralogy of Fallot (21.5%, 56/261) and pulmonary atresia(12.3%,32/261) in order.(3)The type of CHD is unrelated with gender and age in this group(P>0.05).(4)The common clinical manifestations of CHD in this group are murmur (60.0%, 945/1576), murmur combined cyanosis (20.2%, 319/1576) and cyanosis (7.4%, 117/1576).The merely presence of murmur in the type of non-cyanotic CHD was higher than that in the type of cyanotic CHD(P<0.01);murmur combined cyanosis in cyanotic CHD was higher than in non-cyanotic CHD(P<0.01).(5)There is a high incidence of complicated with heart failure in these CHD(15.4%,243/1576) and the incidence in the type of cyantic CHD is higher than that in the type of non-cyantic CHD( P <0.01).The incidence of complicated with heart failure is also associated with the size of the defect.The case with a larger defect is easier to develop the complication of heart failure(P<0.05).(6)There is a high incidence of associated extracardiac malformation (9.5%, 150/1576) in this group of patients with CHD and congenital anal atresia is the most common extracardiac malformation(27.3%,41/150). (27.3%,41/150). Conclusions:Hospitalized neonates with CHD in this group have the following clinical features:(1)CHD contributes a high proportion of the spectrum of disease in hospitalized neonates.The constitution of CHD in this group is different from the general epidemiology investigation.(2)Murmur is the most common clinical manifestation in type of non-cyanotic CHD, and murmur combined cyanosis is the most common clinical manifestation in type of cyanotic CHD.(3)Heart failure is a common complication of CHD, and the incidence is related with the type of CHD and the size of defect.(4)CHD in neonates frequently combined with extracardiac malformations.