Delivery room asphyxia in neonates with ductal-dependent congenital heart disease: a retrospective cohort study

Abstract

We aimed to investigate the clinical course and outcome of newborns with ductal-dependent congenital heart disease (CHD) who suffered from perinatal asphyxia. Clinical data of 504 patients with ductal-dependent CHD and perinatal asphyxia were retrospectively analyzed over a 10-year period (2005–2014). Perinatal asphyxia was diagnosed in 17 (3.4%) patients, comprising two nonoverlapping groups: Five infants with intrauterine acidosis (umbilical artery pH\u2009<\u20097.0), and 12 infants with persistent or deteriorating postnatal depression (Apgar score <6 at 10\u2009min of life). Preoperative (41.7%, p\u2009<\u20090.001) and overall mortality (50.0%, p\u2009=\u20090.001) were increased in infants with asphyxia caused by persistent or deteriorating postnatal depression. Apgar scores at 10\u2009min were independently associated with preoperative (OR 0.479, 95% CI 0.342–0.672, p\u2009<\u20090.001) and overall death (OR 0.655, 95% CI 0.537–0.799, p\u2009<\u20090.001). Asphyxia caused by postnatally deteriorating depression rather than fetal acidosis is associated with high mortality.