Consultant Neonatologist The Coombe Hospital Dublin, Dublin, Ireland
Background: The Vermont Oxford Network (VON) is an international collaborative network for neonatology. Liveborn neonates with birth weight < 1500g and/or gestational age < 30 weeks are eligible for VON entry. Information pertaining to select major Congenital Heart Diseases (CHD) are recorded within VON. The Republic of Ireland (ROI) has contributed data to VON, concerning infants with CHD, since 2014. Survival data for such infants for the years 2014 to 2022 are here presented for the ROI and compared to the entire VON global network. Objective: To describe the survival to discharge for extreme preterm infants with CHD within the ROI VON database and compare to the overall global VON network for 2014 to 2022. Design/Methods: The National Perinatal Epidemiology Centre (NPEC) based at University College Cork in the ROI serves as the clinical audit centre and repository for the ROI VON database. The VON NPEC electronic database was searched for all infants with major CHD for 2014 to 2022. The VON database includes all liveborn infants with birth weight < 1500g and/or gestational age < 30 weeks. The VON Nightingale electronic database was searched for all VON network data pertaining to infants with major CHD for the same years. Infants with postnatal arrhythmias were only included if there was either congenital heart block or major structural CHD. Infants with only a diagnosis of patent ductus arteriosus were excluded from this study. Consent for database searches were obtained from the Children's Health Ireland Research Ethics Committee. Results: For the years 2014 to 2022 there were 103 infants with major CHD and extreme prematurity within the VON ROI database. This represents 2.1% of the total ROI VON population. For this same study interval the incidence of major CHD within the entire global VON ranged from 1.2 to 2.5% of all VON births. Table 1. illustrates the diagnostic characterization of these infants in the ROI. VSD and pulmonary valvular stenosis, each respectively 17.4%, represent the most common major CHD. Table 2. depicts survival to discharge from NICU for selected major CHD both for ROI and the entire global VON network. It is noteworthy that for the study years 2014-2022, no infant with either Transposition of the Great Arteries (TGA) or Hypoplastic Left Heart Syndrome (HLHS) have survived to NICU discharge, within either the ROI or global VON network.
Conclusion(s): In the ROI VON network there is a comparable incidence of major CHD to the entire global VON network. There is very high mortality prior to NICU discharge for select major CHD diagnoses such as TGA and HLHS.
