Document Detail


The impact of prenatal diagnosis of complex congenital heart disease on neonatal outcomes.
MedLine Citation:
PMID:  20165844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Prenatal diagnosis of congenital heart disease (CHD) is increasingly common. However, the current impact of prenatal diagnosis on neonatal outcomes is unclear. Between January 2004 and January 2008, a retrospective chart review of infants who underwent surgical repair of CHD before discharge at our institution was conducted. Obstetric and perioperative variables were recorded. Of 439 neonates, 294 (67%) were diagnosed prenatally (PREdx). Infants with PREdx had a lower mean birth weight (3.0 +/- 0.6 vs. 3.1 +/- 0.6 kg, p = 0.002) and gestational age (37.9 +/- 2.1 vs. 38.6 +/- 2.4 wk, p < 0.001) than those with postnatal diagnosis (POSTdx). Severe lesions were more likely to be PREdx: Neonates with single-ventricle (SV) physiology (n = 130 patients [31.2%]) had increased odds of PREdx (n = 113/130, odds ratio [OR] 4.7; 95% confidence interval [CI] 2.7-8.2, p < 0.001). PREdx was associated with decreased preoperative intubation (OR 0.62; 95% CI 0.42-0.95, p = 0.033), administration of antibiotics (OR 0.23; 95% CI 0.15-0.36, p < 0.001), cardiac catheterization (OR 0.54; 95% CI 0.34-0.85, p = 0.01), and emergency surgery (OR 0.18; 95% CI 0.06-0.5, p < 0.001) compared with POSTdx infants. There was no difference in APGAR scores, preoperative pH, day of life of surgery, operative complications, hospital length of stay, or overall mortality in the PREdx versus POSTdx groups, even when controlling for lesion severity. PREdx was not independently associated with neonatal mortality, despite having included more severe cardiac lesions. PREdx was significantly associated with decreased neonatal morbidity in terms of decreased use of preoperative ventilator, administration of antibiotics, cardiac catheterization, and emergency surgery.
Authors:
Allison Levey; Julie S Glickstein; Charles S Kleinman; Stephanie M Levasseur; Jonathan Chen; Welton M Gersony; Ismee A Williams
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-02-18
Journal Detail:
Title:  Pediatric cardiology     Volume:  31     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-17     Completed Date:  2010-10-14     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  587-97     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Chi-Square Distribution
Female
Gestational Age
Heart Defects, Congenital / diagnosis*,  mortality,  surgery
Humans
Infant Mortality
Infant, Newborn
Length of Stay / statistics & numerical data
Logistic Models
Male
Pregnancy
Pregnancy Outcome
Prenatal Diagnosis*
Prevalence
Proportional Hazards Models
Retrospective Studies
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
KL2 RR024157/RR/NCRR NIH HHS; KL2 RR024157/RR/NCRR NIH HHS; KL2 RR024157-01/RR/NCRR NIH HHS
Comments/Corrections

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