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Hydrops fetalis—trends in associated diagnoses and mortality from 1997–2018

Journal of Perinatology volume 41, pages 2537–2543 (2021)Cite this article

Subjects

Abstract

Objectives

To describe and evaluate trends in the etiology and mortality risk in neonates admitted for neonatal intensive care with hydrops fetalis.

Study design

A retrospective review of de-identified patient data in the Pediatrix Clinical Data Warehouse from 1997 to 2018.

Results

We identified 2144 infants diagnosed with hydrops fetalis. The most common diagnoses were congenital heart disease (n = 325, 15.2%), genetic diagnoses (n = 269, 12.5%) and cardiac arrhythmia (n = 176, 8.2%). Of 2144 neonates, 988 (46%) survived to hospital discharge and 775 (36%) died prior to discharge. Mortality rate was highly variable across diagnoses, ranging from 90% in infants with congenital diaphragmatic hernia to 0% in infants with atrial flutter. Over the study period, more infants were diagnosed with trisomies and fewer with twin-to-twin transfusion. Mortality decreased by 5% from 1997–2007 to 2008–2018.

Conclusions

The risk of death among neonates with hydrops fetalis is highly dependent on the underlying cause, with increasing risk of mortality at lower gestational ages.

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Fig. 1: Mortalty by diagnosis: mortality rate by diagnosis and diagnostic category for infants with hydrops fetalis (infants transferred prior to discharge excluded).
Fig. 2: Mortality by gestational age: mortality rate by estimated gestational age at birth (infants transferred prior to discharge excluded).

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Authors and Affiliations

  1. The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL, USA

    Veeral N. Tolia, Kaashif A. Ahmad & Reese H. Clark

  2. Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, TX, USA

    Veeral N. Tolia

  3. Pediatrix Medical Group, Dallas, TX, USA

    Veeral N. Tolia, Bezalel Perelmuter & Joshua A. Frankfurt

  4. University of South Carolina School of Medicine Greenville, Greenville, SC, USA

    R. Hunter Clark Jr.

  5. Baylor College of Medicine, San Antonio, TX, USA

    Kaashif A. Ahmad

  6. Pediatrix Medical Group of San Antonio, San Antonio, TX, USA

    Kaashif A. Ahmad

  7. Obstetrix Medical Group of Phoenix Neonatology, Phoenix, AZ, USA

    Matthew E. Abrams

  8. Division of Medical Genetics, Department of Pediatrics, Duke University, Durham, NC, USA

    Jennifer L. Cohen

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  1. Veeral N. Tolia
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Correspondence to Veeral N. Tolia.

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Tolia, V.N., Hunter Clark, R., Perelmuter, B. et al. Hydrops fetalis—trends in associated diagnoses and mortality from 1997–2018. J Perinatol 41, 2537–2543 (2021). https://doi.org/10.1038/s41372-021-01179-3

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