Prenatal diagnosis of critical congenital heart disease reduces risk of death from cardiovascular compromise prior to planned neonatal cardiac surgery: a meta-analysis
Open accessAbstract
OBJECTIVE: To determine if prenatal diagnosis improves the chance that a newborn with critical congenital heart disease will survive to undergo planned cardiac surgery. METHODS: A systematic review of the medical literature identified eight studies which met the following criteria: compared outcomes between newborns with prenatal and those with postnatal diagnosis of critical congenital heart disease; compared groups of patients with the same anatomical diagnosis; provided detailed information on cardiac anatomy; included detailed information on preoperative cause of death. A meta-analysis was performed to assess differences in preoperative mortality rates between newborns with prenatal diagnosis and those with postnatal diagnosis. Patients with established risk factors for increased mortality (high risk) and those whose families chose comfort care rather than cardiac surgery were excluded. RESULTS: In patients with comparable anatomy, standard risk, a parental desire to treat and optimal care, newborns with a prenatal diagnosis of critical congenital heart disease were significantly less likely to die prior to planned cardiac surgery than were those with a comparable postnatal diagnosis (pooled odds ratio, 0.26; 95% CI, 0.08-0.84). CONCLUSIONS: For newborns most likely to benefit from treatment for their critical congenital heart disease, because they did not have additional risk factors and their families pursued treatment, prenatal diagnosis reduced the risk of death prior to planned cardiac surgery relative to patients with a comparable postnatal diagnosis. Further study and efforts to improve prenatal diagnosis of congenital heart disease should therefore be considered.
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Prenatal diagnosis of CHD significantly improves neonatal morbidity and mortality.
“Prenatal diagnosis of CHD significantly improves neonatal morbidity and mortality.137,138”
From Artificial intelligence in obstetric ultrasound: A scoping review. (2023) · cites this paper as [137]
The Discussion (page not provided) reports improved preoperative survival after prenatal diagnosis, but only for newborns with critical CHD under specified care conditions. It says the analysis did not show a decrease in all-cause mortality, and the paper does not establish a significant improvement in neonatal morbidity. The claim therefore extends beyond the outcomes and population supported by this source. (LLM, conf=0.88)
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- Authors
- Holland, B. J., Myers, J. A., & Woods, C. R.
- Affiliations
- University of Louisville (US)
- Corresponding author
- Holland, B. J.
- ORCID
- Myers, J. A.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2015-06
- Volume
- 45
- Issue
- 6
- Pages
- 631-638
- ISSN
- 0960-7692 (ISSN-L)
- OpenAlex
- W1855607912
- Semantic Scholar
- a382f9b3a95b02a587e2fb814984b12e7e1a7f60
- Cited by
- 286
- References
- 58
- Citations by year
- 2026: 25 · 2025: 27 · 2024: 33 · 2023: 46 · 2022: 34 · 2021: 35 · 2020: 20 · 2019: 14 · 2018: 24 · 2017: 16 · 2016: 8 · 2015: 4
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Louisville
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- critical congenital heart disease, prenatal diagnosis, preoperative mortality, neonatal cardiac surgery, postnatal diagnosis, fetal echocardiography, congenital heart disease outcomes
- MeSH terms
- Female, Heart Defects, Congenital, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, Risk Factors, Ultrasonography, Prenatal
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