alexa Prenatal diagnosis, birth location, surgical center, and neonatal mortality in infants with hypoplastic left heart syndrome.


Journal of Neonatal Biology

Author(s): Morris SA, Ethen MK, Penny DJ, Canfield MA, Minard CG,

Abstract Share this page

Abstract BACKGROUND: Most studies have not demonstrated improved survival after prenatal diagnosis of critical congenital heart disease, including hypoplastic left heart syndrome (HLHS). However, the effect of delivery near a cardiac surgical center (CSC), the recommended action after prenatal diagnosis, on HLHS mortality has been poorly investigated. METHODS AND RESULTS: Using Texas Birth Defects Registry data, 1999 through 2007, which monitored >3.4 million births, we investigated the association between distance (calculated driving time) from birth center to CSC and neonatal mortality in 463 infants with HLHS. Infants with extracardiac birth defects or genetic disorders were excluded. The associations between prenatal diagnosis, CSC HLHS volume, and mortality were also examined. Neonatal mortality in infants born <10 minutes from a CSC was 21.0\%, 10 to 90 minutes 25.2\%, and >90 minutes 39.6\% (P for trend <0.001). Prenatal diagnosis alone was not associated with improved survival (P=0.14). In multivariable analysis, birth >90 minutes from a CSC remained associated with increased mortality (odds ratio, 2.03; 95\% confidence interval, 1.19-3.45), compared with <10 minutes. In subanalysis, birth >90 minutes from a CSC was associated with higher pretransport mortality (odds ratio, 6.69; 95\% confidence interval, 2.52-17.74) and birth 10 to 90 minutes with higher presurgical mortality (odds ratio, 4.45; 95\% confidence interval, 1.17-17.00). Higher surgical mortality was associated with lower CSC HLHS volume (odds ratio per 10 patients, 0.88; 95\% confidence interval, 0.84-0.91). CONCLUSIONS: Infants with HLHS born far from a CSC have increased neonatal mortality, and most of this mortality is presurgical. Efforts to improve prenatal diagnosis of HLHS and subsequent delivery near a large volume CSC may significantly improve neonatal HLHS survival. This article was published in Circulation and referenced in Journal of Neonatal Biology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 29th World Neonatal Nursing and Maternal Healthcare Congress
    August 28-30, 2017 Philadelphia, Pennsylvania, USA
  • 2nd International Conference on Pediatric Neurology
    August 31-September 01, 2017 Prague, Czech Republic
  • 10th World Pediatric Congress
    September 28-29, 2017 Dubai, UAE
  • Infancy, Child Nutrition & Development (ICND)
    October 16-18, 2017 (20 Forums, 3 Days- 1 Event) New York, USA
  • 20th International Conference on Neonatology and Perinatology
    December 04-06, 2017 Madrid, Spain

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version