Frequency and Pattern of Congenital Heart Disease in Term Neonates Presenting in Respiratory Distress at Tertiary Care Hospital, Larkana

Frequency and Pattern of Congenital Heart Disease in Term Neonates

Abstract

Congenital heart disease (CHD) is a leading cause of infant morbidity and mortality. This is particularly the case in resource-limited settings where diagnosis is commonly delayed. Objectives: To assess the frequency and pattern of CHD among term neonates who presented with respiratory distress at a tertiary care hospital in Larkana, Pakistan. Methods: This cross-sectional study was conducted at the Department of Pediatrics, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan, from December 1, 2024, to June 7, 2025. A total of 105 term neonates presenting with respiratory distress were enrolled. Each neonate underwent detailed clinical examination and echocardiographic evaluation to identify structural heart defects. Demographic and perinatal data were also collected to explore associations with different CHD types. Statistical analysis was performed using SPSS version 22.0. Results: CHD was diagnosed in 41.9% of the neonates. The most common defect was a ventricular septal defect (24.8%), followed by an atrial septal defect (15.2%) and patent ductus arteriosus (12.4%). Cyanotic defects were less frequent, with tetralogy of Fallot identified in 6.7% and transposition of the great arteries in 2.9%. No statistically significant associations were found between CHD and neonatal age, gender, or mode of delivery.  Conclusions: A significant proportion of term neonates with respiratory distress had underlying CHD, with acyanotic lesions being more common. These findings support the incorporation of routine echocardiographic screening and timely specialist referral for symptomatic neonates, particularly in resource-constrained healthcare settings.