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  • Original Article
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Neurologic events in neonates treated surgically for congenital heart disease

Journal of Perinatology volume 26, pages 237–242 (2006)Cite this article

Abstract

Objective:

The incidence of acute neurologic events prior to discharge in neonates with congenital heart disease (CHD) was determined and peri-operative characteristics predictive of a neurologic event were identified.

Study design:

A retrospective chart review over 1 year was conducted of infants <1 month of age with a diagnosis of CHD. Outcomes were measured by the occurrence of an acute neurologic event defined as electroencephalogram (EEG)-proven seizure activity, significant hypertonia or hypotonia, or choreoathetosis prior to hospital discharge. Stepwise logistic regression identified variables most likely to be associated with an acute neurologic event.

Results:

Surgical intervention occurred in 95 infants who were admitted with a diagnosis of CHD. The survival rate was 92%. Of the survivors, 16 (17%) had an acute neurologic event, with 19% of events occurring preoperatively. Factors associated with neurologic events included an elevated nucleated red blood cell (NRBC) count, an abnormal preoperative brain imaging study, and a 5-min Apgar score <7 (P<0.05).

Conclusions:

Neonates with CHD have a significant risk of neurologic events. Preoperative brain imaging, the 5-min Apgar score, and initial serum NRBC counts may identify infants at highest risk for central nervous system injury.

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Acknowledgements

We thank William E Benitz, MD for his assistance with the statistical analysis and Stephen J Roth, MD for his critical review of the manuscript. Dr Chock received support from the Neonatal and Developmental Biology Training Grant at Stanford University.

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Authors and Affiliations

  1. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    V Y Chock, D Bernstein & A Madan

  2. Cardiovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA

    V M Reddy

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  1. V Y Chock
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  2. V M Reddy
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  3. D Bernstein
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  4. A Madan
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Corresponding author

Correspondence to A Madan.

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Supplementary Information accompanies the paper on the Journal of Perinatology website (http://www.nature.com/jp)

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Chock, V., Reddy, V., Bernstein, D. et al. Neurologic events in neonates treated surgically for congenital heart disease. J Perinatol 26, 237–242 (2006). https://doi.org/10.1038/sj.jp.7211459

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