Key result
Hispanic ethnicity linked to ~58% lower odds of prenatal CCHD diagnosis.
Why the study?
Prenatal diagnosis of critical congenital heart disease decreases neonatal morbidity and mortality, but contemporary rates and maternal-fetal barriers following 2013 imaging guidelines required evaluation.
What is the contemporary prenatal diagnosis rate of critical congenital heart disease and what factors are associated with it?
Observational (n=339)
No
What is the contemporary prenatal diagnosis rate of critical congenital heart disease and what factors are associated with it?
Prenatal diagnosis rates of critical congenital heart disease remain inadequate at 58%, with significant disparities affecting uninsured and Hispanic communities.
Prenatal CCHD diagnosis rates remain suboptimal with Hispanic disparities; leaves open targeted research on barriers to fetal echocardiography.
Background: Prenatal diagnosis (preDx) of critical congenital heart disease (CCHD) decreases neonatal morbidity and mortality. Obstetrical fetal cardiac imaging guidelines in 2013 aimed to increase preDx. Objective: To determine the contemporary preDx rate of CCHD and identify maternal-fetal factors and variations in prenatal care that may be potential barriers . Methods: This retrospective single center study evaluated maternal demographics and characteristics of infants with CCHD (requiring cardiac catheterization or surgical intervention before 6 months-old) between 2016 and 2019. Results: 58% of the 339 infants with CCHD had preDx. Infants with preDx were more likely to have mothers ≥ 35 years-old (p=0.028), family history of CHD (p=0.017), health insurance (p=0.002), or anatomic scan with perinatology (p<0.001). Hispanic infants were less likely to have preDx (45.6%, p=0.005). PreDx rates were higher in infants with extracardiac/genetic anomalies (p<0.001) and significantly different between CCHD subtypes (76% for single ventricle, 51% for biventricular, 59% for proximal outflow tract anomalies, and 48% for distal great artery anomalies; p=0.024). In infants without preDx, 25% of their mothers had indication for, but did not undergo, fetal echocardiography. Conclusion: PreDx rates of CCHD remains inadequate across subtypes detectable by standard fetal cardiac screening views, particularly in uninsured and Hispanic communities.
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Davtyan et al. (2023) conducted an observational in Critical Congenital Heart Disease (n=339). Maternal-fetal factors and prenatal care variations was evaluated on Prenatal diagnosis rate of CCHD. The contemporary prenatal diagnosis rate of critical congenital heart disease was 58%, with Hispanic infants being significantly less likely to be diagnosed prenatally (OR 0.42).
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