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Disparities in the prenatal detection of critical congenital heart disease. Prenat Diagn 2015 Sep;35(9):859-63

Date

05/21/2015

Pubmed ID

25989740

Pubmed Central ID

PMC4558244

DOI

10.1002/pd.4622

Scopus ID

2-s2.0-84940791927 (requires institutional sign-in at Scopus site)   80 Citations

Abstract

OBJECTIVES: Prenatal diagnosis of critical congenital heart disease, which requires surgical or catheter intervention in the first 30 days of life, allows for delivery at a specialized center and can reduce preoperative morbidity and mortality. We sought to identify the risk factors for a missed prenatal diagnosis of critical congenital heart disease.

METHODS: Patients presenting to the Children's Hospital of Wisconsin with critical congenital heart disease from 2007 to 2013 were included. Those with a prenatal diagnosis were compared with those with a postnatal diagnosis.

RESULTS: The cohort included 535 patients with prenatal diagnosis made in 326 (61%). The prenatal diagnostic rate improved from 44% in 2007 to 69% in 2013. Independent factors associated with a postnatal diagnosis were a lesion that required a view other than a four chamber view to make the diagnosis (p < 0.0001), absence of another organ system anomaly (p < 0.0001), and living in a higher poverty (p = 0.02) or lower population density communities (p = 0.002).

CONCLUSIONS: While the prenatal diagnostic rate for critical congenital heart disease is improving, those living in impoverished or rural communities are at highest risk of not having a diagnosis made prenatally. Interventions to improve prenatal detection of congenital heart disease should target these vulnerable areas.

Author List

Hill GD, Block JR, Tanem JB, Frommelt MA

Authors

Joseph Block MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michele Ann Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Jena B. Tanem APP Inpatient 1 in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Delayed Diagnosis
Female
Healthcare Disparities
Heart Defects, Congenital
Humans
Infant, Newborn
Male
Multivariate Analysis
Pregnancy
Retrospective Studies
Risk Factors
Socioeconomic Factors
Ultrasonography, Prenatal
Wisconsin