Why the study?
Accurate prenatal diagnosis of structural abnormality and heart failure is necessary to predict prognosis in congenital heart disease, prompting investigation into whether cardiovascular profile and biophysical profile scores are useful prognostic predictors.
Do cardiovascular profile (CVP) and biophysical profile (BP) scores predict perinatal and infant mortality in infants prenatally diagnosed with congenital heart defects?
Do cardiovascular profile (CVP) and biophysical profile (BP) scores predict perinatal and infant mortality in infants prenatally diagnosed with congenital heart defects?
Prenatal cardiovascular and biophysical profile scores, particularly a decrease in CVP score in utero, are strong independent predictors of perinatal and infant mortality in congenital heart disease.
AIM: To predict the prognosis of infants with congenital heart disease, accurate prenatal diagnosis of structural abnormality and heart failure are both necessary. The aim of this study was to investigate whether cardiovascular profile (CVP) and biophysical profile (BP) scores are useful for predicting prognosis in infants with congenital heart defect (CHD). METHODS: A retrospective review of singletons prenatally diagnosed with CHD at a tertiary pediatric cardiac center between 2011 and 2015 was undertaken. RESULTS: A total of 202 patients with CHD were analyzed. Perinatal and infant deaths occurred in 16 (7.9%) and 10 cases (5.0%), respectively. Infants with the last CVP score ≤ 5 had 18.7-fold higher perinatal mortality than those with a last CVP score > 5 (P < 0.01). Infants with a last BP score ≤ 6 had 18.7-fold higher perinatal mortality than those with a last BP score > 6 (P < 0.01). Infants with a CVP score decrease in utero had 4.5-fold higher infant mortality than those with an increase or no change (P < 0.01). Multivariate analysis showed that single-ventricle physiology, pre-term birth at <37 weeks of gestation, last CVP score ≤ 5, and last BP score ≤ 6 were independent predictors of perinatal mortality. Single-ventricle physiology and a CVP score decrease were independent predictors of infant mortality. CONCLUSION: CVP and BP scores are useful for predicting perinatal prognosis in infants with CHD. A CVP score decrease in utero is associated with infant mortality, suggesting that serial CVP score assessment may be useful for management planning.
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Miyoshi et al. (2019) studied this question.
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