Prenatal detection of congenital heart disease

Area of Science:

• Cardiology
• Prenatal Diagnosis
• Pediatrics

Background:

• Congenital heart disease (CHD) is a significant cause of infant mortality.
• Prenatal detection of CHD can influence management and outcomes.
• Current rates of prenatal CHD detection require evaluation.

Purpose of the Study:

• To determine the frequency of prenatal detection of major congenital heart disease (CHD).
• To identify factors influencing prenatal CHD diagnosis.
• To assess the impact of prenatal CHD detection on the postnatal course.

Main Methods:

• Prospective study of fetuses and infants up to 6 months with major CHD at 3 referral centers.
• Data collection included prenatal and demographic information, prenatal ultrasound (US), and postnatal records.
• Logistic regression analysis was used to identify risk factors for prenatal diagnosis.

Main Results:

• Only 28% of infants with major CHD were diagnosed prenatally, despite 99% having prenatal US.
• Detection rates varied significantly by CHD type, with heterotaxy (82%) highest and anomalous pulmonary venous return (0%) lowest.
• Prenatal diagnosis was associated with less frequent mechanical ventilation and prostaglandin treatment postnatally.

Conclusions:

• Prenatal detection of major CHD is low but significantly impacts postnatal management and outcomes.
• The type of CHD and the healthcare setting (university vs. community practice) are key factors influencing detection rates.
• Improved prenatal screening strategies are needed to increase the detection of congenital heart disease.