Skip to main content
Erschienen in: Pediatric Cardiology 3/2013

01.03.2013 | Original Article

Prenatal Diagnosis of Congenital Heart Disease and Birth Outcomes

verfasst von: Benjamin J. Landis, Allison Levey, Stephanie M. Levasseur, Julie S. Glickstein, Charles S. Kleinman, Lynn L. Simpson, Ismee A. Williams

Erschienen in: Pediatric Cardiology | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

This study was undertaken to examine the impact that prenatal diagnosis of congenital heart disease (CHD) has on birth and early neonatal outcomes. The prevalence of prenatally diagnosed CHD has risen over the past decade, but the effect that prenatal diagnosis of CHD has on peripartum decisions remains unclear. No consensus exists on the effect of prenatal diagnosis on neonatal outcomes. Between January 2004 and July 2009, a retrospective chart review of all neonates with CHD admitted to our institution’s neonatal intensive care unit was conducted. Obstetric and postnatal variables were collected. Among the 993 subjects, 678 (68.3 %) had a prenatal diagnosis. A prenatal diagnosis increased the odds of a scheduled delivery [odds ratio (OR) 4.1, 95 % confidence interval (CI) 3.0–5.6] and induction of labor (OR 11.5, 95 % CI 6.6–20.1). Prenatal diagnosis was not significantly associated with cesarean delivery when control was used for maternal age, multiple gestation, and presence of extracardiac anomaly. Mean gestational age had no impact on prenatal diagnosis, but prenatal diagnosis was associated with increased odds of delivery before a gestational age of 39 weeks (OR 1.5, 95 % CI 1.1–1.9) and decreased odds of preoperative intubation (OR 0.5, 95 % CI 0.3–0.6). Prenatal diagnosis did not have an impact on preoperative or predischarge mortality. Prenatal diagnosis was associated with increased odds of a scheduled delivery, birth before a gestational age of 39 weeks, and a decreased need for invasive respiratory support. Prenatal diagnosis of CHD was not associated with preoperative or predischarge mortality.
Literatur
1.
Zurück zum Zitat Abenhaim HA, Benjamin A (2011) Effect of prior cesarean delivery on neonatal outcomes. J Perinat Med 39:241–244PubMedCrossRef Abenhaim HA, Benjamin A (2011) Effect of prior cesarean delivery on neonatal outcomes. J Perinat Med 39:241–244PubMedCrossRef
2.
Zurück zum Zitat Atz AM, Travison TG, Williams IA et al (2010) Prenatal diagnosis and risk factors for preoperative death in neonates with single right ventricle and systemic outflow obstruction: screening data from the Pediatric Heart Network Single Ventricle Reconstruction Trial(*). J Thorac Cardiovasc Surg 140:1245–1250PubMedCrossRef Atz AM, Travison TG, Williams IA et al (2010) Prenatal diagnosis and risk factors for preoperative death in neonates with single right ventricle and systemic outflow obstruction: screening data from the Pediatric Heart Network Single Ventricle Reconstruction Trial(*). J Thorac Cardiovasc Surg 140:1245–1250PubMedCrossRef
3.
Zurück zum Zitat Bonnet D, Coltri A, Butera G et al (1999) Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation 99:916–918PubMedCrossRef Bonnet D, Coltri A, Butera G et al (1999) Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation 99:916–918PubMedCrossRef
4.
Zurück zum Zitat Brown KL, Ridout DA, Hoskote A, Verhulst L, Ricci M, Bull C (2006) Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart 92:1298–1302PubMedCrossRef Brown KL, Ridout DA, Hoskote A, Verhulst L, Ricci M, Bull C (2006) Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart 92:1298–1302PubMedCrossRef
5.
Zurück zum Zitat Cedergren MI, Kallen BA (2006) Obstetric outcome of 6,346 pregnancies with infants affected by congenital heart defects. Eur J Obstet Gynecol Reprod Biol 125:211–216PubMedCrossRef Cedergren MI, Kallen BA (2006) Obstetric outcome of 6,346 pregnancies with infants affected by congenital heart defects. Eur J Obstet Gynecol Reprod Biol 125:211–216PubMedCrossRef
6.
Zurück zum Zitat Chang RR, Gurvitz M, Rodriguez S (2008) Missed diagnosis of critical congenital heart disease. Arch Pediatr Adolesc Med 162:969–974PubMedCrossRef Chang RR, Gurvitz M, Rodriguez S (2008) Missed diagnosis of critical congenital heart disease. Arch Pediatr Adolesc Med 162:969–974PubMedCrossRef
7.
Zurück zum Zitat Chew C, Halliday JL, Riley MM, Penny DJ (2007) Population-based study of antenatal detection of congenital heart disease by ultrasound examination. Ultrasound Obstet Gynecol 29:619–624PubMedCrossRef Chew C, Halliday JL, Riley MM, Penny DJ (2007) Population-based study of antenatal detection of congenital heart disease by ultrasound examination. Ultrasound Obstet Gynecol 29:619–624PubMedCrossRef
8.
Zurück zum Zitat Costello JM, Polito A, Brown DW et al (2010) Birth before 39 weeks’ gestation is associated with worse outcomes in neonates with heart disease. Pediatrics 126:277–284PubMedCrossRef Costello JM, Polito A, Brown DW et al (2010) Birth before 39 weeks’ gestation is associated with worse outcomes in neonates with heart disease. Pediatrics 126:277–284PubMedCrossRef
9.
Zurück zum Zitat Daubeney PE, Sharland GK, Cook AC, Keeton BR, Anderson RH, Webber SA (1998) Pulmonary atresia with intact ventricular septum: impact of fetal echocardiography on incidence of birth and postnatal outcome. Circulation 98:562–566PubMedCrossRef Daubeney PE, Sharland GK, Cook AC, Keeton BR, Anderson RH, Webber SA (1998) Pulmonary atresia with intact ventricular septum: impact of fetal echocardiography on incidence of birth and postnatal outcome. Circulation 98:562–566PubMedCrossRef
10.
Zurück zum Zitat De Luca R, Boulvain M, Irion O, Berner M, Pfister RE (2009) Incidence of early neonatal mortality and morbidity after late preterm and term cesarean delivery. Pediatrics 123:e1064–e1071PubMedCrossRef De Luca R, Boulvain M, Irion O, Berner M, Pfister RE (2009) Incidence of early neonatal mortality and morbidity after late preterm and term cesarean delivery. Pediatrics 123:e1064–e1071PubMedCrossRef
11.
Zurück zum Zitat Eapen RS, Rowland DG, Franklin WH (1998) Effect of prenatal diagnosis of critical left heart obstruction on perinatal morbidity and mortality. Am J Perinatol 15:237–242PubMedCrossRef Eapen RS, Rowland DG, Franklin WH (1998) Effect of prenatal diagnosis of critical left heart obstruction on perinatal morbidity and mortality. Am J Perinatol 15:237–242PubMedCrossRef
12.
Zurück zum Zitat Franklin O, Burch M, Manning N, Sleeman K, Gould S, Archer N (2002) Prenatal diagnosis of coarctation of the aorta improves survival and reduces morbidity. Heart 87:67–69PubMedCrossRef Franklin O, Burch M, Manning N, Sleeman K, Gould S, Archer N (2002) Prenatal diagnosis of coarctation of the aorta improves survival and reduces morbidity. Heart 87:67–69PubMedCrossRef
13.
Zurück zum Zitat Friedberg MK, Silverman NH, Moon-Grady AJ et al (2009) Prenatal detection of congenital heart disease. J Pediatr 155:26–31PubMedCrossRef Friedberg MK, Silverman NH, Moon-Grady AJ et al (2009) Prenatal detection of congenital heart disease. J Pediatr 155:26–31PubMedCrossRef
14.
Zurück zum Zitat Hofbeck M, Beinder M, Kirchgessner E, Buheitel G, Singer H (1997) Perinatal management of children with prenatal diagnosis of congenital heart defects. Z Geburtshilfe Neonatal 201:49–54 Hofbeck M, Beinder M, Kirchgessner E, Buheitel G, Singer H (1997) Perinatal management of children with prenatal diagnosis of congenital heart defects. Z Geburtshilfe Neonatal 201:49–54
15.
Zurück zum Zitat Khoshnood B, De Vigan C, Vodovar V et al (2005) Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in France, 1983–2000: a population-based evaluation. Pediatrics 115:95–101PubMed Khoshnood B, De Vigan C, Vodovar V et al (2005) Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in France, 1983–2000: a population-based evaluation. Pediatrics 115:95–101PubMed
16.
Zurück zum Zitat Kuller JA, Katz VL, Wells SR, Wright LN, McMahon MJ (1996) Cesarean delivery for fetal malformations. Obstet Gynecol Surv 51:371–375PubMedCrossRef Kuller JA, Katz VL, Wells SR, Wright LN, McMahon MJ (1996) Cesarean delivery for fetal malformations. Obstet Gynecol Surv 51:371–375PubMedCrossRef
17.
Zurück zum Zitat Kumar RK, Newburger JW, Gauvreau K, Kamenir SA, Hornberger LK (1999) Comparison of outcome when hypoplastic left heart syndrome and transposition of the great arteries are diagnosed prenatally versus when diagnosis of these two conditions is made only postnatally. Am J Cardiol 83:1649–1653PubMedCrossRef Kumar RK, Newburger JW, Gauvreau K, Kamenir SA, Hornberger LK (1999) Comparison of outcome when hypoplastic left heart syndrome and transposition of the great arteries are diagnosed prenatally versus when diagnosis of these two conditions is made only postnatally. Am J Cardiol 83:1649–1653PubMedCrossRef
18.
Zurück zum Zitat Lee YM, D’Alton ME (2008) Cesarean delivery on maternal request: the impact on mother and newborn. Clin Perinatol 35:505–518PubMedCrossRef Lee YM, D’Alton ME (2008) Cesarean delivery on maternal request: the impact on mother and newborn. Clin Perinatol 35:505–518PubMedCrossRef
19.
Zurück zum Zitat Mahle WT, Clancy RR, McGaurn SP, Goin JE, Clark BJ (2001) Impact of prenatal diagnosis on survival and early neurologic morbidity in neonates with the hypoplastic left heart syndrome. Pediatrics 107:1277–1282PubMedCrossRef Mahle WT, Clancy RR, McGaurn SP, Goin JE, Clark BJ (2001) Impact of prenatal diagnosis on survival and early neurologic morbidity in neonates with the hypoplastic left heart syndrome. Pediatrics 107:1277–1282PubMedCrossRef
20.
Zurück zum Zitat Martin JA (2010) Births: final data for 2007. Natl Vital Stat Rep 58:1–85PubMed Martin JA (2010) Births: final data for 2007. Natl Vital Stat Rep 58:1–85PubMed
21.
Zurück zum Zitat Mellander M (2005) Perinatal management, counselling and outcome of fetuses with congenital heart disease. Semin Fetal Neonatal Med 10:586–593PubMedCrossRef Mellander M (2005) Perinatal management, counselling and outcome of fetuses with congenital heart disease. Semin Fetal Neonatal Med 10:586–593PubMedCrossRef
22.
Zurück zum Zitat Montana E, Khoury MJ, Cragan JD et al (1996) Trends and outcomes after prenatal diagnosis of congenital cardiac malformations by fetal echocardiography in a well defined birth population, Atlanta, Georgia, 1990–1994. J Am Coll Cardiol 28:1805–1809PubMedCrossRef Montana E, Khoury MJ, Cragan JD et al (1996) Trends and outcomes after prenatal diagnosis of congenital cardiac malformations by fetal echocardiography in a well defined birth population, Atlanta, Georgia, 1990–1994. J Am Coll Cardiol 28:1805–1809PubMedCrossRef
23.
Zurück zum Zitat Morrison JJ, Rennie JM, Milton PJ (1995) Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective cesarean section. Br J Obstet Gynaecol 102:101–106PubMedCrossRef Morrison JJ, Rennie JM, Milton PJ (1995) Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective cesarean section. Br J Obstet Gynaecol 102:101–106PubMedCrossRef
24.
Zurück zum Zitat [No authors listed] (2006) NIH State-of-the-Science Conference Statement on cesarean delivery on maternal request. NIH Consens State Sci Statements 23:1–29 [No authors listed] (2006) NIH State-of-the-Science Conference Statement on cesarean delivery on maternal request. NIH Consens State Sci Statements 23:1–29
25.
Zurück zum Zitat Rasiah SV, Ewer AK, Miller P et al (2008) Antenatal perspective of hypoplastic left heart syndrome: 5 years on. Arch Dis Child Fetal Neonatal Ed 93:F192–F197PubMedCrossRef Rasiah SV, Ewer AK, Miller P et al (2008) Antenatal perspective of hypoplastic left heart syndrome: 5 years on. Arch Dis Child Fetal Neonatal Ed 93:F192–F197PubMedCrossRef
26.
Zurück zum Zitat Reis PM, Punch MR, Bove EL, van de Ven CJ (1998) Obstetric management of 219 infants with hypoplastic left heart syndrome. Am J Obstet Gynecol 179:1150–1154PubMedCrossRef Reis PM, Punch MR, Bove EL, van de Ven CJ (1998) Obstetric management of 219 infants with hypoplastic left heart syndrome. Am J Obstet Gynecol 179:1150–1154PubMedCrossRef
27.
Zurück zum Zitat Sharland GK, Lockhart SM, Chita SK, Allan LD (1991) Factors influencing the outcome of congenital heart disease detected prenatally. Arch Dis Child 66:284–287PubMedCrossRef Sharland GK, Lockhart SM, Chita SK, Allan LD (1991) Factors influencing the outcome of congenital heart disease detected prenatally. Arch Dis Child 66:284–287PubMedCrossRef
28.
Zurück zum Zitat Signore C (2008) Neonatal morbidity and mortality after elective cesarean delivery. Clin Perinatol 35:361–371PubMedCrossRef Signore C (2008) Neonatal morbidity and mortality after elective cesarean delivery. Clin Perinatol 35:361–371PubMedCrossRef
29.
Zurück zum Zitat Sivarajan V, Penny DJ, Filan P, Brizard C, Shekerdemian LS (2009) Impact of antenatal diagnosis of hypoplastic left heart syndrome on the clinical presentation and surgical outcomes: the Australian experience. J Paediatr Child Health 45:112–117PubMedCrossRef Sivarajan V, Penny DJ, Filan P, Brizard C, Shekerdemian LS (2009) Impact of antenatal diagnosis of hypoplastic left heart syndrome on the clinical presentation and surgical outcomes: the Australian experience. J Paediatr Child Health 45:112–117PubMedCrossRef
30.
Zurück zum Zitat Tita AT, Landon MB, Spong CY et al (2009) Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med 360:111–120PubMedCrossRef Tita AT, Landon MB, Spong CY et al (2009) Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med 360:111–120PubMedCrossRef
31.
Zurück zum Zitat Tworetzky W, McElhinney DB, Reddy VM, Brook MM, Hanley FL, Silverman NH (2001) Improved surgical outcome after fetal diagnosis of hypoplastic left heart syndrome. Circulation 103:1269–1273PubMedCrossRef Tworetzky W, McElhinney DB, Reddy VM, Brook MM, Hanley FL, Silverman NH (2001) Improved surgical outcome after fetal diagnosis of hypoplastic left heart syndrome. Circulation 103:1269–1273PubMedCrossRef
32.
Zurück zum Zitat Tzifa A, Barker C, Tibby SM, Simpson JM (2007) Prenatal diagnosis of pulmonary atresia: impact on clinical presentation and early outcome. Arch Dis Child Fetal Neonatal Ed 92:F199–F203PubMedCrossRef Tzifa A, Barker C, Tibby SM, Simpson JM (2007) Prenatal diagnosis of pulmonary atresia: impact on clinical presentation and early outcome. Arch Dis Child Fetal Neonatal Ed 92:F199–F203PubMedCrossRef
33.
Zurück zum Zitat Verheijen PM, Lisowski LA, Stoutenbeek P et al (2001) Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient. J Thorac Cardiovasc Surg 121:798–803PubMedCrossRef Verheijen PM, Lisowski LA, Stoutenbeek P et al (2001) Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient. J Thorac Cardiovasc Surg 121:798–803PubMedCrossRef
34.
Zurück zum Zitat Williams IA, Shaw R, Kleinman CS et al (2008) Parental understanding of neonatal congenital heart disease. Pediatr Cardiol 29:1059–1065PubMedCrossRef Williams IA, Shaw R, Kleinman CS et al (2008) Parental understanding of neonatal congenital heart disease. Pediatr Cardiol 29:1059–1065PubMedCrossRef
35.
Zurück zum Zitat Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D (2004) Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective cesarean delivery. Acta Paediatr 93:643–647PubMedCrossRef Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D (2004) Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective cesarean delivery. Acta Paediatr 93:643–647PubMedCrossRef
Metadaten
Titel
Prenatal Diagnosis of Congenital Heart Disease and Birth Outcomes
verfasst von
Benjamin J. Landis
Allison Levey
Stephanie M. Levasseur
Julie S. Glickstein
Charles S. Kleinman
Lynn L. Simpson
Ismee A. Williams
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
Pediatric Cardiology / Ausgabe 3/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-012-0504-4

Weitere Artikel der Ausgabe 3/2013

Pediatric Cardiology 3/2013 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.