Evaluation of patients consulted to pediatric cardiology from the newborn department

In the neonatal period, early diagnosis and treatment of cardiovascular diseases are of vital importance. This study aims to retrospectively review the cardiac evaluations of patients, examine the indications for consultation and consultation outcomes along with potential influencing parameters, classify identified cardiac diseases, compare them with similar studies, and shed light on new research by highlighting any deficiencies or differences. This study is a retrospective analysis of patients (n=804) referred from the neonatal department to pediatric cardiology at Konya Necmettin Erbakan University Faculty of Medicine Hospital between June 2016 and September 2021. Data were obtained from the hospital records. When creating patient groups based on consultation outcomes, echocardiographic evaluation was given priority, resulting in two independent groups: congenital heart diseases (CHD) and normal evaluations. IBM SPSS Statistics 27.0 was used for the statistical analysis of the data, with a significance level set at p<0.05 to determine statistical significance. In our study, 52.1% (n=419) of patients were classified as having CHD (Congenital Heart Diseases) based on the consultation outcomes. Additionally, during the consultations, arrhythmia was detected in 5.1% (n=41) of patients, with 15 of them also having CHD, and myocarditis was identified in 0.2% (n=2) of patients. Of all the patients, 46.3% (n=372) were female, and 53.7% (n=432) were male. Furthermore, it was determined that 89.6% (n=720) were born from singleton pregnancies, and 10.4% (n=84) were born from multiple pregnancies. Male infants had significantly higher 5-minute APGAR scores and birth weights compared to female infants (p<0.05). Infants born from multiple pregnancies had significantly lower gestational age and birth weight compared to infants from singleton pregnancies (p<0.05). It was determined that 18.9% of the patients (n=152) were born through normal spontaneous vaginal delivery, while 81.1% (n=652) were born via cesarean section. Patients with identified CHD had significantly lower gestational age, birth weight, birth length, and birth head circumference compared to patients with normal echocardiographic evaluations (p<0.05). In 19.3% of the mothers (n=155), endocrine disorders were identified, with diabetes and thyroid diseases being the most common in this group. The most commonly used medication in this group was levothyroxine (7.7%). Among infants of mothers with a history of smoking or substance use, cardiac and/or non-cardiac anomalies were detected in 75.7% of cases (n=25). It was found that 26.9% of the patients included in the study had consanguinity between their parents. In families with a history of cardiac disease in individuals under the age of 30, congenital heart disease was identified in 52.6% of cases (n=20). The most common reason for consultation was a murmur, accounting for 22.1% (n=186) of cases. There was a statistically significant difference in terms of pulse rate and SpO2 values during consultation between patients with identified CHD and those with normal evaluations (p<0.05). The most frequent cardiac physical examination finding was a murmur, observed in 52.8% of cases (n=424). Among the echocardiographic evaluations, ventricular septal defect was the most common (24%). Major cardiac anomalies were present in 4.5% of patients (n=36), with Fallot's tetralogy being the most frequently identified. Additionally, 23.7% of patients (n=191) had extracardiac anomalies, with Down syndrome being the most frequently diagnosed (9.4%, n=77). According to the consultation outcomes, 14.2% of patients (n=114) were recommended for medical and/or surgical treatment. During the study, a screening revealed that 10.9% of patients (n=88) had passed away, with 8% (n=7) of them having isolated cardiac causes for their demise. Keywords: neonate, cardiology, consultation, congenital heart disease, arrhythmia, myocarditis