ABSTRACT
Background: Congenital heart defects (CHDs) are the most prevalent birth anomalies and result from complex genetic and environmental factors. Beyond structural abnormalities, adverse intrauterine conditions may influence fetal development and contribute to long-term health outcomes. This study aimed to evaluate clinical and hematological markers of developmental vulnerability in a cohort of patients with CHD. Materials and Methods: A retrospective clinical analysis was conducted in 52 pediatric patients at the Institute of Cardiovascular Diseases (IBCV), Iași, Romania. Maternal clinical histories, hematological parameters (hemoglobin [Hb] and white blood cell [WBC] count), and neonatal parameters (birth weight, Apgar score, and birth Z-score) were analyzed. Results: Mean birth weight was 3,043.46 ± 642.34 g. Patients with cyanotic CHD had higher mean Hb concentrations than those with non-cyanotic CHD (13.82 vs. 12.82 g/dL), although the difference was not statistically significant (p = 0.170). Patients with identified genetic syndromes had significantly lower mean birth Z-scores than those without identified genetic syndromes (−1.26 vs. −0.57; p = 0.028). Conclusions: The lower birth Z-scores observed in patients with identified genetic syndromes suggest an association between genetic abnormalities and impaired fetal growth. The higher Hb concentrations observed in patients with cyanotic CHD, although not statistically significant, may reflect a compensatory response to chronic hypoxia. These readily available clinical parameters may provide additional information on developmental vulnerability in patients with CHD. Larger prospective studies are needed to clarify their potential role in long-term risk assessment and clinical follow-up.