Perinatal and perioperative factors associated with mortality and an increased need for hospital care in infants with transposition of the great arteries: A nationwide 11-year population-based cohort

Johanna Hautala, Mika Gissler, Annukka Ritvanen, Emmi Helle, Jaana Pihkala, Ilkka P. Mattila, Tommi Pätilä, Jukka Salminen, Juha Puntila, Eero Jokinen, Juha Räsänen, Tero Vahlberg, Tiina Ojala

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Newborn infants with transposition of the great arteries (d-TGA) need immediate care for an optimal outcome. This study comprised a nationwide 11-year population-based cohort of d-TGA infants, and assessed whether the implementation of a nationwide systematic fetal screening program, or other perinatal, or perioperative factors, are associated with mortality or an increased need for hospital care. Material and methods: The national cohort consisted of all live-born infants with simple d-TGA (TGA ± small ventricular septal defect, n = 127) born in Finland during 2004-2014. Data were collected from six national registries. Prenatal diagnosis and perinatal and perioperative factors associated with mortality and length of hospitalization were evaluated. Results: Preoperative mortality was 7.9%, and the total mortality was 8.7%. The prenatal detection rate increased after introducing systematic fetal anomaly screening from 5.0% to 37.7% during the study period (P <.0001), but the total mortality rate remained unchanged. All prenatally diagnosed infants (n = 27) survived. Lower gestational age (odds ratio 0.68, P =.012) and higher maternal age at birth (odds ratio 1.16, P =.036) were associated with increased mortality in multivariable analysis. Older infant age at time of operation (P =.002), longer aortic clamp time (P <.001), and higher maternal body mass index (P =.027) were associated with longer initial hospital stay. An extended need for hospital care during the first year of life was multi-factorial. Conclusions: In our cohort, none of the prenatally diagnosed d-TGA infants died. As a result of the limited prenatal detection rates, however, the sample size was insufficient to reach statistical significance. The d-TGA infants born with lower gestational age and to older mothers had increased mortality.

Original languageEnglish (US)
Pages (from-to)1728-1735
Number of pages8
JournalActa obstetricia et gynecologica Scandinavica
Volume99
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • hospitalization
  • maternal body mass index
  • mortality
  • prenatal diagnosis
  • transposition of great arteries
  • transposition of great vessels

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Fingerprint

Dive into the research topics of 'Perinatal and perioperative factors associated with mortality and an increased need for hospital care in infants with transposition of the great arteries: A nationwide 11-year population-based cohort'. Together they form a unique fingerprint.

Cite this