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Prenatal diagnosis of congenital heart disease and birth outcomes

Benjamin J Landis1, Allison Levey, Stephanie M Levasseur

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY, USA. benjaminlandis4@yahoo.com

Pediatric Cardiology
|October 12, 2012
PubMed

Insights

Prenatal diagnosis of congenital heart disease (CHD) influences delivery timing and reduces the need for respiratory support. However, it does not impact mortality rates in neonates.

Area of Science:

  • Neonatal outcomes
  • Congenital heart disease
  • Prenatal diagnosis

Background:

  • The prevalence of prenatally diagnosed congenital heart disease (CHD) has increased.
  • The impact of prenatal CHD diagnosis on peripartum decisions and neonatal outcomes is not well-established.
  • Existing literature lacks consensus on the effects of prenatal diagnosis on neonatal outcomes.

Purpose of the Study:

  • To investigate the impact of prenatal diagnosis of congenital heart disease (CHD) on birth and early neonatal outcomes.
  • To clarify the association between prenatal CHD diagnosis and peripartum management strategies.
  • To determine if prenatal diagnosis influences neonatal mortality and morbidity.

Main Methods:

  • Retrospective chart review of neonates with CHD admitted to a neonatal intensive care unit between January 2004 and July 2009.
  • Collection of obstetric and postnatal variables for 993 neonates.
  • Statistical analysis using odds ratios (OR) and 95% confidence intervals (CI) to assess associations.

Main Results:

  • A prenatal diagnosis of CHD was associated with increased odds of scheduled delivery (OR 4.1) and labor induction (OR 11.5).
  • Prenatal diagnosis correlated with delivery before 39 weeks gestation (OR 1.5) and decreased need for preoperative intubation (OR 0.5).
  • No significant association was found between prenatal diagnosis and cesarean delivery, or preoperative/predischarge mortality.

Conclusions:

  • Prenatal diagnosis of CHD leads to more scheduled deliveries and earlier births.
  • Neonates with prenatally diagnosed CHD may require less invasive respiratory support.
  • Prenatal diagnosis of CHD does not appear to affect neonatal mortality rates.

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