Key result
Prenatal screening detects only ~13% of CHD cases despite near-universal obstetric follow-up.
Why the study?
Prenatal detection of congenital heart disease remains suboptimal in resource-limited settings.
What are the rates of prenatal CHD detection and predictors of counseling for fetal echocardiography in a developing country?
What are the rates of prenatal CHD detection and predictors of counseling for fetal echocardiography in a developing country?
Calls for integration of obstetric and pediatric cardiology services in resource-limited settings; extends evidence of gaps in prenatal CHD detection and counseling.
Objective Prenatal detection of congenital heart disease (CHD) remains suboptimal in resource‐limited settings. We quantified prenatal CHD detection, fetal echocardiography utilization, and predictors of counseling for fetal echocardiography in future pregnancies. Method We surveyed parents of children with CHD, capturing key sociodemographics, obstetric history, prenatal screening, use of fetal echocardiography, and future counseling. We compared prenatal versus postnatal diagnoses and used multivariable logistic regression to identify counseling predictors. Results Among 362 families, only 48 children (13.3%) were diagnosed prenatally, despite nearly universal obstetric follow‐up (99.7%) and moderate prenatal ultrasound screening (59.4%). Prenatal ultrasound screening was more frequent among prenatally diagnosed cases (97.9% vs. 53.5%; p < 0.001). Fetal echocardiography was more common when extracardiac malformations were suspected and in moderate‐to‐complex CHD ( p < 0.001). Only 113/362 (31.2%) of families reported receiving counseling for future pregnancies. In multivariable analysis, greater CHD complexity was independently associated with counseling (OR 3.21; p < 0.001), whereas family history of CHD was not ( p = 0.91). Conclusions Prenatal CHD detection was uncommon and driven by screening practices. Counseling regarding fetal echocardiography was inconsistently delivered and concentrated on complex CHD. These findings highlight gaps in referral and counseling, supporting the need for stronger integration between obstetric and pediatric cardiology services.
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Hammoud et al. (2026) studied this question. Prenatal detection of congenital heart disease occurred in only 13.3% of cases despite 99.7% obstetric follow-up, with future pregnancy counseling provided to just 31.2% of families.
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