Gestational Age Associated With Infant Death, Even Some Considered Full-term

Saturday, January 28, 2012

The national trend toward infants being born at lower gestational ages may have significant, negative consequences for infants with congenital heart disease – even those considered full-term.

A full-term pregnancy is one that goes between 37 and 40 weeks, but a Cincinnati Children’s Hospital Medical Center study finds that the death rate more than doubles in infants with congenital heart diseases born at 37 weeks compared to those born at 40 weeks.

James Cnota, MD, a pediatric cardiologist at the Cincinnati Children’s Heart Institute, presented his findings on Monday, November 16, at the annual meeting of the American Heart Association in Orlando.

“Pediatric cardiologists traditionally have considered any full-term birth acceptable, with the same level of risk. That thinking may be wrong,” says Dr. Cnota. “Our results say that babies with heart defects are more likely to survive if the pregnancy reaches a full 40 weeks.”

Dr. Cnota analyzed 14.9 million live births in the United States between 2000 and 2003. Of these, 4,736 with congenital heart disease died in the first year of life. Death rates decreased with each successive week of gestation: Fifty-eight of every 100,000 live births at 37 weeks died, while 24 of every 100,000 live births at 40 weeks died.

“When congenital heart disease is diagnosed prenatally, pediatric cardiologists need to work with their obstetrical colleagues to understand how the final weeks of pregnancy affect outcomes and to devise strategies to optimize the length of pregnancy,” says Dr. Cnota.

The nation’s preterm birth rate has increased by 36 percent since the 1980s, and despite a decline since 2007, the number of babies born too soon continues to top more than 540,000 each year, according to the March of Dimes.

About Cincinnati Children’s

Cincinnati Children’s Hospital Medical Center is one of 10 children’s hospitals in the United States to make the Honor Roll in U.S. News and World Reports 2009-10 America’s Best Children’s Hospitals issue. It is #1 ranked for digestive disorders and is also highly ranked for its expertise in respiratory diseases, cancer, neonatal care, heart care, neurosurgery, diabetes, orthopedics, kidney disorders and urology. One of the three largest children’s hospitals in the U.S., Cincinnati Children’s is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.

President Barack Obama in June 2009 cited Cincinnati Children’s as an “island of excellence” in health care. For its achievements in transforming health care, Cincinnati Children’s is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases. Additional information can be found at www.cincinnatichildrens.org.