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Preterm congenital heart disease and neurodevelopment: the importance of looking beyond the initial hospitalization

Journal of Perinatology volume 43, pages 958–962 (2023)Cite this article

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Abstract

Congenital heart disease (CHD) and prematurity are leading causes of infant mortality in the United States. Infants with CHD born prematurely are often described as facing “double jeopardy” with vulnerability from their underlying heart disease and from organ immaturity. They endure additional complications of developing in the extrauterine environment while healing from interventions for heart disease. While morbidity and mortality for neonates with CHD have declined over the past decade, preterm neonates with CHD remain at higher risk for adverse outcomes. Less is known about their neurodevelopmental and functional outcomes. In this perspective paper, we review the prevalence of preterm birth among infants with CHD, highlight the medical complexity of these infants, and emphasize the importance of exploring outcomes beyond survival. We focus on current knowledge regarding overlaps in the mechanisms of neurodevelopmental impairment associated with CHD and prematurity and discuss future directions for improving neurodevelopmental outcomes.

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Fig. 1: Major determinants of neurodevelopmental outcomes in preterm infants with congenital heart disease.

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Funding

T-32 Neonatal Research Training Program 5T32HD098061 (JAK), Farb Family Fund (JWN).

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Authors and Affiliations

  1. Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA, USA

    Jenna A. Katz, Philip T. Levy & Sarah U. Morton

  2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Jenna A. Katz, Philip T. Levy, Sarah U. Morton & Jane W. Newburger

  3. Departments of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA

    Samantha C. Butler & Anjali Sadhwani

  4. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Samantha C. Butler & Anjali Sadhwani

  5. Department of Pediatrics, UC Davis, Sacramento, CA, USA

    Satyan Lakshminrusimha

  6. Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Jane W. Newburger

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Katz, J.A., Levy, P.T., Butler, S.C. et al. Preterm congenital heart disease and neurodevelopment: the importance of looking beyond the initial hospitalization. J Perinatol 43, 958–962 (2023). https://doi.org/10.1038/s41372-023-01687-4

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