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Major congenital heart disease: antenatal detection, patient characteristics and outcomes

Angela McBrien1, Andrew Sands, Brian Craig

  • 1Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK. angela.mcbrien@belfasttrust.hscni.net

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|December 17, 2008
PubMed

Insights

Antenatal screening detected major congenital heart disease (CHD) in 27% of cases in Northern Ireland. Babies diagnosed before birth had more complex heart defects and poorer outcomes, highlighting the importance of obstetric screening.

Area of Science:

  • Cardiology
  • Prenatal Diagnosis
  • Public Health

Background:

  • Major congenital heart disease (CHD) presents a significant global health challenge.
  • Antenatal diagnosis of CHD is crucial for improving neonatal outcomes.
  • Northern Ireland's CHD detection rates require evaluation.

Purpose of the Study:

  • To determine the antenatal detection rate of major congenital heart disease (CHD) in Northern Ireland (NI) from 2002 to 2006.
  • To compare the characteristics and prognosis of infants with antenatally versus postnatally diagnosed CHD.
  • To assess the impact of obstetric screening on antenatal CHD detection.

Main Methods:

  • Retrospective data collection from fetal, neonatal, and post-mortem records.
  • Analysis of variables including antenatal diagnosis, karyotype, referral indication, defect type, and neonatal outcome.
  • Comparison of outcomes between antenatal and postnatal diagnosis groups.

Main Results:

  • Twenty-seven percent of major CHD cases were detected antenatally.
  • Antenatally diagnosed CHD cases had higher rates of lethal trisomies (15% vs. 2%) and functionally univentricular hearts (47% vs. 7%).
  • Obstetric screening accounted for the majority (82%) of antenatal CHD diagnoses.

Conclusions:

  • The antenatal detection rate for major CHD in Northern Ireland aligns with European averages.
  • Antenatal diagnosis is associated with more complex CHD, increased risk of karyotype abnormalities, and poorer neonatal outcomes.
  • A regional training program for obstetric sonographers has been implemented to enhance screening capabilities.
Abstract

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