Testing the Fetus Before Birth can Provide Earlier Treatment for Heart Problems

New study highlights the importance of prenatal diagnosis to optimize surgical timing and the long-term health of the baby born with congenital heart defects.

Prenatal diagnosis, or diagnosis that happens before birth is linked with earlier surgery for babies born with heart disease since birth (congenital heart defects), the most common birth defect affecting nearly 1% of all live births. This was shown in a study from Ann & Robert H. Lurie Children’s Hospital of Chicago.

The association was demonstrated for critical defects (when heart surgery is required before the infant leaves the hospital) and certain types of noncritical defects, which constitute about 75% of all congenital heart defects ().

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‘Infants diagnosed with critical heart disease before birth had their surgery earlier for the development of the brain and other organs.#CongentialHeartDisease #HeartSurgery #PrenatalDiagnosis’

The benefits of prenatal diagnosis of congenital heart defects for babies have been debated. With the knowledge that earlier heart surgery is often better for a child’s development, investigators at Lurie Children’s have found that prenatally diagnosed babies born with critical heart disease had surgery on average one week sooner than those with postnatal diagnosis.

Surgery for babies with prenatally diagnosed noncritical cardiac defects occurred anywhere from two to 12 months sooner. The results were published in the journal Circulation: Cardiovascular Quality and Outcomes.

Quantifying the Importance of Prenatal Diagnosis for Infants with Congenital Heart Disease

They analyzed a cohort of 1,131 patients with congenital heart defects, aged 0-9 years, who received their initial cardiac surgery at Lurie Children’s between 2015 and 2021. Nearly half of these patients had the prenatal diagnosis.

After accounting for demographics, comorbidities, and surgical complexity, the average age at surgery was significantly younger in infants with prenatally versus postnatally diagnosed critical and noncritical congenital heart disease ().

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Infants with one of the most common types of noncritical disease called atrial septal defects had surgery about a year sooner. For infants with critical disease especially, getting surgery a week earlier can make a big difference in the development of the brain and other organs.

This study shows that the best care for kids starts with prenatal diagnosis. More research is needed to identify and overcome the barriers to prenatal diagnosis ().

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These can include social barriers such as distance to care, lack of childcare, or inability to take time off from work. We need a better understanding of these factors to provide the highest quality care to babies born with cardiac defects, and their families.

References:

Prenatal Diagnosis: Screening and Diagnostic Tools - (https://www.sciencedirect.com/science/article/abs/pii/S0889854517300153?via%3Dihub)
Impacts of prenatal diagnosis of congenital heart diseases on outcomes - (https://tp.amegroups.org/article/view/58602/html)
Association Between Prenatal Diagnosis and Age at Surgery for Noncritical and Critical Congenital Heart Defects - (https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.122.009638)

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