{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T20:10:09Z","timestamp":1781208609803,"version":"3.54.1"},"reference-count":66,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,6]]},"abstract":"<jats:sec id=\"jah38492-sec-0001\" sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Low 5\u2010minute Apgar scores (AS) are predictive of term and preterm neonatal mortality but have not been well studied in the critical congenital heart disease (CCHD) population. We analyzed US national vital statistics data to evaluate the association between neonatal depression (AS 0\u20133) and 1\u2010year mortality in CCHD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah38492-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We performed a retrospective cohort study using 2014 to 2018 Centers for Disease Control and Prevention cohort\u2010linked birth certificate and infant death records. Five\u2010minute AS were categorized as \u22643, 4 to 6, or \u22657. We calculated birth rates and associated mortality rates by AS group in infants with and without CCHD. Multivariable logistic regression analyzed neonatal, maternal, and pregnancy\u2010related risk factors for neonatal depression and 1\u2010year mortality. Of 11\u2009642 neonates with CCHD (0.06% of all births), the 5.8% with AS 0 to 3 accounted for 23.3% of all 1\u2010year CCHD mortality, with 69.9% of deaths occurring within 1\u2009month of life. Gestational age at birth, growth restriction, extracardiac defects, race, and low maternal education were associated with an increased odds of AS 0 to 3 in neonates with CCHD relative to those with AS 7 to 10 on multivariable analysis. AS 0 to 3 was associated with 1\u2010year CCHD mortality after adjusting for these factors, prenatal care, and delivery location (adjusted odds ratio, 14.57 [95% CI, 11.73\u201318.10]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah38492-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The AS is a routine clinical measure providing important prognostic information in CCHD. These findings suggest that prenatal and perinatal factors, beyond those included in current risk stratification tools, are important for CCHD outcomes. Multidisciplinary collaboration to understand the pathophysiology underlying neonatal depression may help identify interventions to improve CCHD mortality rates.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028774","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T10:52:46Z","timestamp":1685616766000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Neonatal Depression Is Associated With 1\u2010Year Mortality in Critical Congenital Heart Disease"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-4384","authenticated-orcid":false,"given":"Kimberley G.","family":"Miles","sequence":"first","affiliation":[{"name":"Cincinnati Children\u2019s 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