High rates of congenital airway anomalies in neonates with single ventricle congenital heart disease

Neonates with single ventricle congenital heart disease (SV CHD) may have noncardiac comorbidities, including congenital airway anomalies (CAA). Using a national administrative database, we analyzed neonatal admissions with ICD-10 codes for SV CHD with and without CAA from October 2020 to December 2024, excluding admissions with genetic syndromes to reduce confounding by the potential contribution of syndromes to CAA. Among 5144 neonatal admissions with SV CHD, 535 (10.4%) had CAA, compared to 23,837 (0.4%) of 5,942,621 neonatal admissions without CHD (odds ratio [OR] [95% confidence interval]: 28.9 [26.4, 31.7], P < 0.001). Neonates with SV CHD and CAA had longer lengths of stay, more complications, inhospital mortality, and higher hospital costs compared to those without CAA. This study highlights the markedly higher prevalence of CAA in neonates with SV CHD and the negative impact on hospital outcomes.