TY - JOUR
T1 - The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies
T2 - A European Register-Based Cohort Study
AU - Heino, Anna
AU - Morris, Joan K.
AU - Garne, Ester
AU - Baldacci, Silvia
AU - Barisic, Ingeborg
AU - Cavero-Carbonell, Clara
AU - García-Villodre, Laura
AU - Given, Joanne
AU - Jordan, Sue
AU - Loane, Maria
AU - Lutke, L. Renée
AU - Neville, Amanda J.
AU - Santoro, Michele
AU - Scanlon, Ieuan
AU - Tan, Joachim
AU - de Walle, Hermien E.K.
AU - Kiuru-Kuhlefelt, Sonja
AU - Gissler, Mika
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/6
Y1 - 2024/6
N2 - Objectives: To compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally. Methods: Population-based registers’ data were linked to hospital and mortality databases. Results: Children whose anomaly was diagnosed prenatally (n = 1088) had a lower mean gestational age than those diagnosed postnatally (n = 1698) ranging from 8 days for CDH to 4 days for TGA. Children with CDH had the highest infant mortality rate with a significant difference (p < 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06). Conclusions: Our findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. Appropriate prenatal counselling about the time and mode of delivery is needed.
AB - Objectives: To compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally. Methods: Population-based registers’ data were linked to hospital and mortality databases. Results: Children whose anomaly was diagnosed prenatally (n = 1088) had a lower mean gestational age than those diagnosed postnatally (n = 1698) ranging from 8 days for CDH to 4 days for TGA. Children with CDH had the highest infant mortality rate with a significant difference (p < 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06). Conclusions: Our findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. Appropriate prenatal counselling about the time and mode of delivery is needed.
KW - Congenital diaphragmatic hernia
KW - Gastroschisis
KW - Prenatal diagnosis
KW - Spina bifida
KW - Transposition of great arteries
UR - http://www.scopus.com/inward/record.url?scp=85186632288&partnerID=8YFLogxK
U2 - 10.1007/s10995-024-03911-9
DO - 10.1007/s10995-024-03911-9
M3 - Article
C2 - 38438690
AN - SCOPUS:85186632288
SN - 1092-7875
VL - 28
SP - 1020
EP - 1030
JO - Maternal and child health journal
JF - Maternal and child health journal
IS - 6
ER -