How prenatal diagnosis associated with earlier surgery for babies

Prenatal diagnosis, or diagnosis before a baby is born, is connected with earlier surgery for kids with congenital heart abnormalities, the most prevalent birth disorders affecting roughly 1 per cent of all live births, according to a study from Ann & Robert H. Lurie Children's Hospital of Chicago.

The link was found for both critical problems (when heart surgery is required before the newborn is discharged from the hospital) and certain types of noncritical defects, which account for around 75 per cent of all congenital heart defects.

The advantages of prenatal detection of congenital heart abnormalities for infants have been questioned. With the understanding that early heart surgery is frequently beneficial for a child's growth, Lurie Children's researchers discovered that prenatally diagnosed newborns born with serious heart illness underwent surgery one week sooner than those with postnatal diagnosis. Prenatally detected noncritical heart abnormalities were operated on between two and twelve months earlier. The findings were published in Circulation: Cardiovascular Quality and Outcomes.

 “Our study quantifies the tremendous importance of prenatal diagnosis for infants with congenital heart disease,” said lead author Joyce Woo, MD, MS, cardiologist at Lurie Children’s and Assistant Professor of Pediatrics and Medical Social Sciences at Northwestern University Feinberg School of Medicine. “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. Earlier surgery for certain types of noncritical congenital heart disease can also prevent poor outcomes, such as heart failure. Our findings emphasize that prenatal diagnosis is crucial to optimize surgical timing and the long-term health of the baby. Prenatal diagnosis needs to be equitably accessible to all pregnant people.”

Dr. Woo and colleagues 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 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. Infants with one of the most common types of noncritical disease, called atrial septal defects, had surgery about a year sooner.

“Our 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,” said Dr. Woo. “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 in order to provide the highest quality care to babies born with cardiac defects, and their families.”