Key result
Prenatal diagnosis of congenital heart disease was associated with similar 30-day survival compared to post-natal diagnosis (71.2% vs 72.9%; p>0.1) in neonates requiring emergent cardiac procedures.
Why the study?
Does prenatal diagnosis improve 30-day survival in neonates with congenital heart disease requiring emergent intervention compared to post-natal diagnosis?
Cohort (n=111)
No
Does prenatal diagnosis improve 30-day survival in neonates with congenital heart disease requiring emergent intervention compared to post-natal diagnosis?
Absolute Event Rate: 71.2% vs 72.9%
p-value: p=>0.1
Prenatal diagnosis of congenital heart disease requiring emergent neonatal intervention does not significantly improve overall 30-day survival but is associated with a lower need for intubation and a trend toward lower mortality in HLH/HLHC patients.
PURPOSE: We compared outcome of neonates with prenatal and post-natal diagnosis of congenital heart disease presenting in our paediatric heart centre between March 2005 and May 2015 who underwent an emergent intervention within 48 h post-partum. MATERIALS AND METHODS: In 52/111 (46.8%) with emergent intervention, congenital heart disease was diagnosed prenatally, in 59/111 (53.2%) with no specialized foetal echocardiography, diagnosis was made post-natally. In 98/111 (88.2%), 30-day outcome was known. RESULTS: Regarding the entire cohort, 30-day survival did not differ significantly in prenatal and post-natal diagnosis group (71.2 vs. 72.9%; p > .1). Infants with prenatal diagnosis were more likely to be born by caesarean section (59.6% vs. 33.9%, p = .01). Those with post-natal diagnosis had a higher need for intubation (32.7% vs. 52.5%; p < .05). Subgroup analysis of HLH/HLHC (hypoplastic left heart/hypoplastic left heart complex) patients revealed higher number of deaths within 30 days of life in the post-natal diagnosis group, although the difference did not reach statistical significance (5/7, 71.4% vs. 5/20, 25.0%; p = .075). CONCLUSION: For newborns who require emergent neonatal cardiac procedures, our results point towards a lower death rate after prenatal diagnosis of HLH/HLHC.
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Wolter et al. (2017) conducted a cohort in Congenital heart disease (n=111). Prenatal diagnosis vs. Post-natal diagnosis was evaluated on 30-day survival (p=>0.1). Prenatal diagnosis of congenital heart disease was associated with similar 30-day survival compared to post-natal diagnosis (71.2% vs 72.9%; p>0.1) in neonates requiring emergent cardiac procedures.
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