Initial national investigation of the prenatal diagnosis of congenital heart malformations in Japan-Regional Detection Rate and Emergency Transfer from 2013 to 2017

Matsui, Hikoro; Hirata, Yasutaka; Inuzuka, Ryo; Hayashi, Taiyu; Nagamine, Hiroki; Ueda, Tomomi; Nakayama, Tsuneyoshi

doi:10.1016/j.jjcc.2021.08.013

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…In San Diego between 2015 and 2016, prenatal detection rates of critical outflow tract anomalies was 61% [13]. In Japan between 2013 and 2017, 41% of infants with CCHD were diagnosed prenatally [28]. In Sweden between 2013 and 2017, 56% of infants with CCHD were diagnosed prenatally, with the prenatal detection rate for single ventricle lesions being 100% compared to 9% for TGA, an outflow tract anomaly [23].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis Rate of Critical Congenital Heart Disease Remains Inadequate with Significant Racial/Ethnic and Socioeconomic Disparities and Technical Barriers

Davtyan,

Ostler,

Golding

et al. 2023

Pediatr Cardiol

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Prenatal diagnosis (preDx) of critical congenital heart disease (CCHD) decreases neonatal morbidity and mortality. Obstetrical fetal cardiac imaging guidelines in 2013 aimed to increase preDx. The objectives of this study were to determine the contemporary preDx rate of CCHD and identify maternal–fetal factors and variations in prenatal care that may be potential barriers. This retrospective single center study evaluated maternal demographics and characteristics of infants with CCHD (requiring cardiac catheterization or surgical intervention before 6 months-old) between 2016 and 2019. 58% of the 339 infants with CCHD had preDx. Infants with preDx were more likely to have mothers ≥ 35 years-old (p = 0.028), family history of CHD (p = 0.017), health insurance (p = 0.002), or anatomic scan with perinatology (p < 0.001). Hispanic infants were less likely to have preDx (45.6%, p = 0.005). PreDx rates were higher in infants with extracardiac/genetic anomalies (p < 0.001) and significantly different between CCHD subtypes (76% for single ventricle, 51% for biventricular/four-chamber view, 59% for proximal outflow tract anomalies, and 48% for distal great artery anomalies; p = 0.024). In infants without preDx, 25% of their mothers had indication for, but did not undergo, fetal echocardiography. PreDx rates of CCHD remains inadequate across subtypes detectable by standard fetal cardiac screening views, particularly in uninsured and Hispanic communities.

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Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis Rate of Critical Congenital Heart Disease Remains Inadequate with Significant Racial/Ethnic and Socioeconomic Disparities and Technical Barriers

Davtyan,

Ostler,

Golding

et al. 2023

Pediatr Cardiol

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“…Despite the ability to diagnose almost all major CHD in utero with a false-negative rate of less than 5% in tertiary fetal cardiology practice 10 , the current rate of detection at screening ultrasound, even in developed countries, ranges from 30% to 60% [11][12][13][14][15] . Although the ease of detection of CHD subtypes at obstetric anatomic screening ultrasound is likely to be a significant predictor of prenatal diagnosis 16,17 , other factors may also play a role, including socioeconomic status (SES) and remoteness of residence (RoR) from tertiary-care obstetric ultrasound screening programs.…”

Section: Introductionmentioning

confidence: 99%

Impact of rural residence and low socioeconomic status on rate and timing of prenatal detection of major congenital heart disease in a jurisdiction of universal health coverage

Kaur

Hornberger

Fruitman

et al. 2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?Of 1405 cases of major congenital heart disease (CHD), a prenatal diagnosis was made in 814. Residence in rural areas, compared with residence < 100 km from a tertiary fetal cardiology center, was associated with a 7% lower rate of prenatal diagnosis of major CHD and 19% higher rate of late diagnosis i.e. after 22 weeks' gestation. Low socioeconomic status was associated with lower prenatal-diagnosis rate in metropolitan regions and higher risk of prenatal diagnosis after 22 weeks overall. What are the clinical implications of this work?Despite universal healthcare in Alberta, Canada, socioeconomic and regional inequalities in prenatal fetal cardiac diagnoses exist. To improve CHD outcomes, further efforts are required to identify modifiable underlying reasons for these findings and to guide novel and targeted health service delivery.

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“…Prenatal detection rates for CHD have increased with improved ultrasound technology, the use of the early fetal echocardiography, and standardization of the performance of the fetal echocardiogram 8–12 . Accurate prenatal detection of CHD, particularly complex CHD, allows for patient autonomy in deciding pregnancy continuation as well as for proper delivery planning, including transfer to appropriate level care center, and coordination of care at time of delivery for conditions requiring an immediate postnatal intervention or evaluation 13–15 . However, some studies have disputed the advantages of an accurate prenatal diagnosis of CHD on improving postnatal outcomes 16 …”

Section: Introductionmentioning

confidence: 99%

Impact of prenatally diagnosed congenital heart defects on outcomes and management

Wong

Kohari

Bahtiyar

et al. 2022

J of Clinical Ultrasound

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Fetal echocardiogram aids in prenatal identification of neonates at high risk for congenital heart defects (CHD). Prenatal detection rates for CHD have increased with improved ultrasound technology, the use of the early fetal echocardiography, and standardization of the performance of the fetal echocardiogram. Accurate prenatal detection of CHD, particularly complex CHD, is an important contributor to improved survival rates for patients with CHD. Early detection allows for families to choose whether or not to continue with pregnancy, referral to pediatric cardiology specialists for patient education, and delivery planning. Better psychosocial supports are needed for families with CHD.

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Initial national investigation of the prenatal diagnosis of congenital heart malformations in Japan-Regional Detection Rate and Emergency Transfer from 2013 to 2017

Cited by 6 publications

References 27 publications

Prenatal Diagnosis Rate of Critical Congenital Heart Disease Remains Inadequate with Significant Racial/Ethnic and Socioeconomic Disparities and Technical Barriers

Prenatal Diagnosis Rate of Critical Congenital Heart Disease Remains Inadequate with Significant Racial/Ethnic and Socioeconomic Disparities and Technical Barriers

Impact of rural residence and low socioeconomic status on rate and timing of prenatal detection of major congenital heart disease in a jurisdiction of universal health coverage

Impact of prenatally diagnosed congenital heart defects on outcomes and management

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