This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Morrow, W. R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Morrow, W. R.
Related Collections
Right arrow Perinatal Practice
Right arrow Cardiology

AAP Grand Rounds 2:61-62 (1999)
© 1999 American Academy of Pediatrics

CARDIOLOGY

Early Newborn Discharge and Death from Congenital Heart Disease

Source: Kuehl KS, Loffredo CA, et al. Failure to diagnose congenital heart disease in infancy. Pediatrics. 1999;103:743–747.

The first 20% of the full text of this article appears below.

A number of publications have addressed the pitfalls of early newborn discharge. This report addresses the risk of early discharge of newborns (less than 2 days of age) and death from congenital heart disease. The authors examined data from the Baltimore-Washington Infant Study of 4,390 infants with congenital cardiovascular malformations (CCVM) recognized from 1981–1989. Only cases unrecognized prior to death and identified at autopsy or by death certificate were analyzed. Characteristics of these patients and sociodemographic features were examined.

Eighteen percent (790) of the 4,390 patients with CCVM died in the first year of life, and of the fatal cases 76 or 9.6% were not diagnosed until after death (ie, were identified by community search). In 45 of 69 infants (information not available for 7 patients), death was not anticipated. Overall, 1.7% (76/4390) of patients with CCVM died prior to recognition of the defect but only 1% (45/4390) of infants with CCVM died unexpectedly before diagnosis. The 76 patients with CCVM who died before diagnosis of the CCVM were more likely to have multiple malformations, chromosomal anomalies (particularly trisomy), low birth weight, prematurity, and intrauterine growth retardation. Eighty percent of the . . . [Full Text of this Article]

W. Robert Morrow, MD, FAAP
Cardiology, Arkansas Children’s Hospital, Little Rock, AR