Yael Pasternak1,2, Gili Man El1,2, Jacob Man El3, Hiba Daas1,2, Yehonatan Pasternak2,4, Netanella Miller1,2 and Alina Weissmann-Brenner1,2*
1Department of Obstetrics and Gynecology, Meir Medical Center, Israel
2Sackler School of Medicine, Tel Aviv University, Israel
3Hebrew University, Jerusalem, Israel
4Department of Pediatrics, Schneider Children's Medical Center, Israel
Background: Congenital Heart Defects (CHD) is the leading cause of neonatal morbidity and mortality among birth defects with a prevalence of 6 per 1,000 live births. In utero diagnosis necessitates multidisciplinary prenatal counseling regarding the options and outcomes. Our aim was to examine the short-term outcomes during the prenatal period and following birth, as well as long-term morbidity and mortality.
Methods: This retrospective study included all fetuses diagnosed with CHD from January 2004 to January 2009. CHDs were categorized as simple or complex. Data regarding pregnancy characteristics and outcomes was retrieved from the department’s patient database. Data regarding long-term follow-up and developmental characteristics was obtained by telephone questionnaire following parental consent. Simple and complex CHD were compared.
Results: Eighty-nine fetuses were diagnosed with CHD. Median follow-up was 12.3 ± 1.3 years. More pregnancies with complex CHD were terminated (p=0.001) or resulted in perinatal demise (p=0.001). More children with complex CHD underwent cardiac surgery (7.1% vs. 77.8%, P=0.001), and had longer cardiology follow-up (11.4 years ± 3.8 vs. 5.2 ± 4.7 years, P=0.02). In addition, higher rates of difficulties with physical activities such as school gym classes were reported among the group with complex CHD (33.3% vs. 0%, P=0.02). There were no significant differences in neurodevelopmental follow-up between groups.
Conclusion: Complex CHD is associated with short- and long-term clinical morbidity and mortality. These data could contribute to the prenatal counseling given to the parents following the diagnosis.
Congenital heart defects; Fetus; Pregnancy; Ultrasound; Neurodevelopment
Pasternak Y, Gili Man El, Jacob Man El, Daas H, Pasternak Y, Miller N, et al. Long-Term Follow-up of Congenital Cardiac Defects Diagnosed in Utero - A Longitudinal Study. Ann Cardiovasc Surg. 2019; 2(1): 1019.