Association Between Prenatal Diagnosis and Age at Surgery for Noncritical and Critical Congenital Heart Defects
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The relationship between the prenatal diagnosis of congenital heart defects (CHDs) and age at CHD surgery is poorly understood, despite the known relationships between age at surgery and long-term outcomes. The objective of this study was to determine the associations between prenatal diagnosis of CHD and age at surgery, and whether these associations differ for critical and noncritical CHDs. METHODS: This is a cohort analysis of patients aged 0 to 9 years who received their initial cardiac surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago between 2015 and 2021 with prenatal diagnosis as the exposure variable. All data were obtained from the locally maintained Society of Thoracic Surgeons Congenital Heart Surgery Database at Lurie Children’s Hospital. We used multivariable fixed effects regression models to estimate the strength of the association of prenatal diagnosis with age at surgery among patients with critical (surgery ≤60 days) and noncritical (surgery >60 days) CHDs. RESULTS: Of 1131 individuals who met inclusion criteria, 532 (47%) had a prenatal diagnosis, 428 (38%) had critical CHDs, 533 (47%) were female, and the median age at surgery was 119 days (interquartile range, 11–309 days). After controlling for demographics, comorbidities, and surgical complexity, the mean age at surgery was significantly younger in those with prenatally versus postnatally diagnosed critical CHD (7.1 days sooner, P <0.001) and noncritical CHDs (atrial septal defects [12.4 months sooner, P =0.037], ventricular septal defects [6.0 months sooner, P <0.003], and noncritical coarctation of the aorta [1.8 months sooner, P =0.010]). CONCLUSIONS: Younger age at CHD surgery, which is associated with postsurgical neurodevelopmental and physical outcomes, is significantly associated with prenatal CHD diagnosis. This relationship was identified for both critical and noncritical CHDs.
Authors: Joyce L. Woo, Christina Laternser, Brett R. Anderson, William A. Grobman, Michael C. Monge, Matthew M. Davis
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Understanding preferences regarding the offer of elective induction of labor to inform development of a decision support tool, G1520950566, NICHD Maternal Fetal Medicine Units Network, Sustaining Women's Engagement and Enabling Transitions after Gestational Diabetes Mellitus (SWEET), G4473286273, G4772317817, G4815432986, Glycemic Profiles and Pregnancy Outcomes Study (GLOSS), Continuation of the NuMoM2b Heart Health Study, Blood Pressure, Obesity, and Diabetes in Relation to Perinatal and Postpartum Complications, Linking State Medicaid and Congenital Heart Surgical Registry Data: Building Capacity to Assess Disparities in Longitudinal Outcomes and Value for Children with Congenital Heart Disease, Promoting Preconception Care and Diabetes Self-Management among Reproductive-Aged Women with Diabetes: The PREPARED Trial
OpenAlex ID: W4385564708