Relation of Prenatal Diagnosis With One-Year Survival Rate for Infants With Congenital Heart Disease

Impact of prenatal diagnosis of complex congenital heart disease on neonatal and infant morbidity and mortality

“…In addition, it helps the providers and the family to plan and coordinate an effective multidisciplinary care of these patients, well in advance of the delivery of the child . However, the benefits of prenatal diagnosis on morbidity and mortality in these infants are still a subject of debate . In this study, we found that prenatal diagnosis of complex CHD significantly improves the preoperative morbidity, more so with ductal‐dependent cardiac lesions (Table ).…”

“…Also, the enhanced survival benefits as shown in some studies have not been replicated in others. The survival benefits have also been shown to vary with the type of complex CHD . The primary objective of this retrospective study was to assess for any preoperative morbidity benefits associated with the prenatal diagnosis of complex CHD.…”

Association of Prenatal Diagnosis of Critical Congenital Heart Disease With Postnatal Brain Development and the Risk of Brain Injury

“…7,9 However, studies have repeatedly demonstrated no difference in mortality when comparing prenatal vs postnatal diagnosis of complex CHD. 8,12,34–38 In addition, prenatal diagnosis often leads to earlier gestational age at birth and lower birth weight, 9 both associated with poor clinical outcomes such as mortality and an increased length of stay for neonates with critical CHD. 13 Similarly, early studies of prenatal diagnosis found no benefits in long-term neurodevelopmental outcome, a finding potentially explained by early preterm delivery and higher rates of preoperative intensive care therapies.…”

Timing and Mode of Delivery in Prenatally Diagnosed Congenital Heart Disease- an Analysis of Practices within the University of California Fetal Consortium (UCfC)

“…Interestingly, in our cohort, the prenatal diagnosis group waited longer to go to the operating room than the postnatal group, with postnatally diagnosed patients having their operation sooner. Despite not leading to a survival advantage [12, 13], the healthier pre-operative state probably leads to better long-term outcomes overall for those who survive. Specifically, studies have demonstrated improved neurodevelopmental outcomes and better brain health in subjects with TGA and HLHS that are diagnosed prenatally [14, 15].…”

“…In particular, earlier detection of critical CHD requiring a neonatal intervention has allowed for planned deliveries at or near a tertiary hospital with a congenital cardiac surgery program and units equipped to manage these neonates [5, 6]. In addition, prenatal detection of critical CHD has been shown to improve the perioperative condition of these neonates [7, 8, 9, 10, 11]; however, multiple studies have failed to show a survival advantage to prenatal diagnosis [12 13]. Despite not leading to a survival advantage, prenatal diagnosis has been associated with better neurodevelopmental outcome in transposition of the great arteries (TGA) [14] as well as reduced risk of pre-operative brain injury and improved trajectory of postnatal brain development in those with complex CHD [15].…”