Abstract
Prenatal diagnosis of critical congenital heart disease (CHD) is associated with decreased morbidity. It is also associated with lower birth weights and earlier gestational age at delivery. The University of California Fetal Consortium (UCfC) comprises five tertiary medical centers, and was created to define treatment practices. We utilized this consortium to assess delivery patterns and outcomes in subjects with prenatal and postnatal diagnosis of CHD. A retrospective cohort study was conducted on maternal–neonatal pairs diagnosed with complex CHD prenatally (n = 186) and postnatally (n = 110) from 2011 to 2013. Outcomes were assessed between groups after adjusting for disease severity. Prenatally diagnosed subjects were born earlier (38.1 ± 0.11 vs. 39 ± 0.14 weeks, p = < 0.001), and had lower birth weights (2853 ± 49 vs. 3074 ± 58 g, p = 0.005) as compared to postnatal diagnosis. For every week increase in gestational age and 100 g increase in birth weight, length of stay decreased by 12.3 ± 2.7% (p < 0.001) and 3.9 ± 0.9% (p < 0.001). Subjects with prenatal diagnosis were more often born via cesarean both planned (35.6 vs. 26.2%, p = 0.004) and after a trial of labor (13 vs. 7.8%, p = 0.017). Neonates with cesarean delivery trended toward a longer length of stay (2.6 days longer), and were born earlier as compared to other modalities (37.7 ± 0.22 weeks, p = 0.001). Management after prenatal diagnosis of CHD appears to have modifiable disadvantages for maternal and neonatal outcomes. The UCfC provides a platform to study best practices and standardization of care for future studies.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 588-595 |
| Number of pages | 8 |
| Journal | Pediatric Cardiology |
| Volume | 38 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2017 |
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Keywords
- Congenital heart disease
- Outcomes
- Prenatal diagnosis
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Cardiology and Cardiovascular Medicine
Cite this
Timing and Mode of Delivery in Prenatally Diagnosed Congenital Heart Disease- an Analysis of Practices within the University of California Fetal Consortium (UCfC). / Peyvandi, Shabnam; Nguyen, Tina Ahn Thu Thi; Almeida-Jones, Myriam; Boe, Nina; Rhee, Laila; Anton, Tracy; Sklansky, Mark; Tarsa, Maryam; Satou, Gary; Moon-Grady, Anita J.; For The University of California Fetal Consortium (UCfC), The University of California Fetal Consortium (UCfC).
In: Pediatric Cardiology, Vol. 38, No. 3, 01.03.2017, p. 588-595.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Timing and Mode of Delivery in Prenatally Diagnosed Congenital Heart Disease- an Analysis of Practices within the University of California Fetal Consortium (UCfC)
AU - Peyvandi, Shabnam
AU - Nguyen, Tina Ahn Thu Thi
AU - Almeida-Jones, Myriam
AU - Boe, Nina
AU - Rhee, Laila
AU - Anton, Tracy
AU - Sklansky, Mark
AU - Tarsa, Maryam
AU - Satou, Gary
AU - Moon-Grady, Anita J.
AU - For The University of California Fetal Consortium (UCfC), The University of California Fetal Consortium (UCfC)
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Prenatal diagnosis of critical congenital heart disease (CHD) is associated with decreased morbidity. It is also associated with lower birth weights and earlier gestational age at delivery. The University of California Fetal Consortium (UCfC) comprises five tertiary medical centers, and was created to define treatment practices. We utilized this consortium to assess delivery patterns and outcomes in subjects with prenatal and postnatal diagnosis of CHD. A retrospective cohort study was conducted on maternal–neonatal pairs diagnosed with complex CHD prenatally (n = 186) and postnatally (n = 110) from 2011 to 2013. Outcomes were assessed between groups after adjusting for disease severity. Prenatally diagnosed subjects were born earlier (38.1 ± 0.11 vs. 39 ± 0.14 weeks, p = < 0.001), and had lower birth weights (2853 ± 49 vs. 3074 ± 58 g, p = 0.005) as compared to postnatal diagnosis. For every week increase in gestational age and 100 g increase in birth weight, length of stay decreased by 12.3 ± 2.7% (p < 0.001) and 3.9 ± 0.9% (p < 0.001). Subjects with prenatal diagnosis were more often born via cesarean both planned (35.6 vs. 26.2%, p = 0.004) and after a trial of labor (13 vs. 7.8%, p = 0.017). Neonates with cesarean delivery trended toward a longer length of stay (2.6 days longer), and were born earlier as compared to other modalities (37.7 ± 0.22 weeks, p = 0.001). Management after prenatal diagnosis of CHD appears to have modifiable disadvantages for maternal and neonatal outcomes. The UCfC provides a platform to study best practices and standardization of care for future studies.
AB - Prenatal diagnosis of critical congenital heart disease (CHD) is associated with decreased morbidity. It is also associated with lower birth weights and earlier gestational age at delivery. The University of California Fetal Consortium (UCfC) comprises five tertiary medical centers, and was created to define treatment practices. We utilized this consortium to assess delivery patterns and outcomes in subjects with prenatal and postnatal diagnosis of CHD. A retrospective cohort study was conducted on maternal–neonatal pairs diagnosed with complex CHD prenatally (n = 186) and postnatally (n = 110) from 2011 to 2013. Outcomes were assessed between groups after adjusting for disease severity. Prenatally diagnosed subjects were born earlier (38.1 ± 0.11 vs. 39 ± 0.14 weeks, p = < 0.001), and had lower birth weights (2853 ± 49 vs. 3074 ± 58 g, p = 0.005) as compared to postnatal diagnosis. For every week increase in gestational age and 100 g increase in birth weight, length of stay decreased by 12.3 ± 2.7% (p < 0.001) and 3.9 ± 0.9% (p < 0.001). Subjects with prenatal diagnosis were more often born via cesarean both planned (35.6 vs. 26.2%, p = 0.004) and after a trial of labor (13 vs. 7.8%, p = 0.017). Neonates with cesarean delivery trended toward a longer length of stay (2.6 days longer), and were born earlier as compared to other modalities (37.7 ± 0.22 weeks, p = 0.001). Management after prenatal diagnosis of CHD appears to have modifiable disadvantages for maternal and neonatal outcomes. The UCfC provides a platform to study best practices and standardization of care for future studies.
KW - Congenital heart disease
KW - Outcomes
KW - Prenatal diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85009278994&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85009278994&partnerID=8YFLogxK
U2 - 10.1007/s00246-016-1552-y
DO - 10.1007/s00246-016-1552-y
M3 - Article
C2 - 28078382
AN - SCOPUS:85009278994
VL - 38
SP - 588
EP - 595
JO - Pediatric Cardiology
JF - Pediatric Cardiology
SN - 0172-0643
IS - 3
ER -