Congenital heart defects are the most common birth defects in the United States. For newborns with the most severe defects –- those needing lifesaving intervention — later transfer to a cardiac surgical center is linked to longer hospitalization compared to those born at a surgical center, according to a study published in The Journal of Pediatrics . Previous studies have shown that prolonged hospitalization is associated with higher rates of one-year mortality, as well as worse long-term neurodevelopmental outcomes for children born with severe heart defects. Results raise the question of whether reaching a cardiac surgical center sooner could impact outcomes.
“We know that newborns with severe heart defects must receive high-quality care from a big team of specialists to achieve the best outcomes. Our findings highlight how timely access to that care might relate to outcomes also,” said leading author Joyce Woo, MD, MS , pediatric cardiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “A lot of research focuses on optimizing the complex clinical care for these high-risk patients. Far less is known about how these patients and their families actually reach that care.”
In the study, Dr. Woo and colleagues used a statewide administrative database (the Illinois Department of Public Health Adverse Pregnancy Outcomes Reporting System) to analyze data on nearly 1,400 newborns born with the most severe heart defects in Illinois between 2013-2021.
They found that nearly half of the infants with severe heart defects were born at hospitals without cardiac surgery. Compared to those born at a cardiac surgical center, neonates who transferred between 1-3 days of life did not have a significantly longer hospital stay. However, transfer to a surgical hospital after 3 days of life was associated with longer hospital stay after birth.
“Access to life-saving intervention isn’t a guarantee for all newborns with the most complex heart disease. We must make sure that these babies reach the right level of care at the right time,” said Dr. Woo.
Dr. Woo receives salary support from the National Institutes of Health (NIH/NHLBI K01HL171819).
Ann & Robert H. Lurie Children’s Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children’s hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children’s resources are devoted to serving their needs. Research at Lurie Children’s is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report .
The Journal of Pediatrics