Key result
Prenatal diagnosis of CCHD is linked to ~100% lower preoperative mortality and higher one-year survival.
Why the study?
Congenital heart disease is the most common congenital defect, and the impact of an integrated prenatal diagnosis-postnatal treatment management mode on birth, surgery, prognosis, and complications of critical CHD in newborns required investigation.
Does an integrated management mode of prenatal diagnosis-postnatal treatment improve survival and reduce complications in newborns with critical congenital heart disease?
Cohort (n=290)
Does an integrated management mode of prenatal diagnosis-postnatal treatment improve survival and reduce complications in newborns with critical congenital heart disease?
Absolute Event Rate: 0% vs 6.2%
p-value: p=0.028
An integrated management mode of prenatal diagnosis and postnatal treatment for critical congenital heart disease significantly reduces preoperative mortality and improves one-year survival compared to postnatal diagnosis alone.
Supports prenatal diagnosis in critical CHD; leaves open randomized confirmation of survival benefit.
Background: Congenital heart disease (CHD) is the most common congenital defect in human beings. The purpose of this article is to investigate impact of an integrated management mode of ‘prenatal diagnosis-postnatal treatment’ on birth, surgery, prognosis and complications associated with critical CHD (CCHD) in newborns.Methods: A retrospective analysis of the medical records of newborns diagnosed with CCHD were divided into two groups: prenatal diagnosis and postnatal diagnosis. The demographics, clinical characteristics, surgical status, prognosis and complications of the two groups were compared and the differences identified.Results: Among the 290 newborns with CCHD, 97 (33.4%) were prenatally diagnosed and 193 (66.6%) were postnatally diagnosed. Newborns in the prenatal diagnostic group were hospitalized immediately after birth, whereas the median age of admission was 6.00 (3.00–12.00) days in postnatal diagnostic group, P=0.000. In terms of postnatal symptoms and signs, the incidence of anhelation, cyanosis and cardiac murmur was higher in the postnatal diagnostic group. The rates of preoperative intubation, postoperative open chest exploration and treatment abandonment were higher in the postnatal diagnostic group. The postnatal diagnostic group was more prone to postoperative complications, such as pneumonia and hypoxic-ischemic brain damage. The preoperative mortality [0 (0.0%) vs. 12 (6.2%), P=0.028] in the prenatal diagnostic group was lower than that in the postnatal diagnostic group. And the one-year survival rate of the prenatal diagnostic group was higher (log-rank test P=0.034).Conclusions: The integrated management mode of prenatal diagnosis-postnatal treatment can improve postnatal symptoms, reduces complications, reduces preoperative mortality and increases one-year survival rates in newborns with CCHD.
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Zhang et al. (2021) conducted a cohort in critical congenital heart disease (CCHD) (n=290). Prenatal diagnosis vs. Postnatal diagnosis was evaluated on Preoperative mortality (p=0.028). Prenatal diagnosis of critical congenital heart disease was associated with lower preoperative mortality compared to postnatal diagnosis (0.0% vs 6.2%, P=0.028) and higher one-year survival.
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