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Two approaches for newborns with critical congenital heart disease: a comparative study

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Abstract

Background

Prenatal diagnosis and planned peripartum care is an unexplored concept in China. This study aimed to evaluate the effects of the “prenatal diagnosis and postnatal treatment integrated model” for newborns with critical congenital heart disease.

Methods

The medical records of neonates (≤ 28 days) admitted to Fuwai Hospital were reviewed retrospectively from January 2019 to December 2020. The patients were divided into “prenatal diagnosis and postnatal treatment integrated group” (n = 47) and “non-integrated group” (n = 69).

Results

The age of admission to the hospital and the age at surgery were earlier in the integrated group than in the non-integrated group (5.2 ± 7.2 days vs. 11.8 ± 8.0 days, P < 0.001; 11.9 ± 7.0 days vs. 16.5 ± 7.7 days, P = 0.001, respectively). The weight at surgery also was lower in the integrated group than in the non-integrated group (3.3 ± 0.4 kg vs. 3.6 ± 0.6 kg, P = 0.010). Longer postoperative recovery time was needed in the integrated group, with a median mechanical ventilation time of 97 h (interquartile range 51–259 h) vs. 69 h (29–168 h) (P = 0.030) and with intensive care unit time of 13.0 days (8.0–21.0 days) vs. 9.0 days (4.5–16.0 days) (P = 0.048). No significant difference was observed in the all-cause mortality (2.1 vs. 8.7%, P = 0.238), but it was significantly lower in the integrated group for transposition of the great arteries (0 vs. 18.8%, log rank P = 0.032).

Conclusions

The prenatal diagnosis and postnatal treatment integrated model could significantly shorten the diagnosis and hospitalization interval of newborns, and surgical intervention could be performed with a lower risk of death, especially for transposition of the great arteries.

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Data availability

The datasets generated and/or analyzed during the current study were available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully acknowledged the doctors and nurses who were involved in the study.

Funding

This work was supported by National Key R & D Program of China (2017YFC1308100) and Beijing Municipal Science & Technology Commission (Z201100005520001).

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Authors and Affiliations

  1. Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing, 100037, China

    Guan-Xi Wang, Kai Ma, Xu Wang, Lei Qi, Yang Yang, Feng-Qun Mao & Shou-Jun Li

  2. Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing, 100037, China

    Kun-Jing Pang

Authors
  1. Guan-Xi Wang
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  2. Kai Ma
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  4. Xu Wang
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Contributions

GXW collected and analyzed the data and drafted the manuscript. GXW, KM, KJP, XW, and SJL designed the study. KM, LQ, YY, and FQM contributed to the critical revision of the manuscript for important intellectual content, and SJL approved the final version of the manuscript. SJL obtained fundings. All the authors have read and approved the final manuscript.

Corresponding author

Correspondence to Shou-Jun Li.

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Ethical approval

This retrospective study was conducted at department of pediatric cardiac surgery, Fuwai Hospital in Beijing, China. It was approved by our institutional ethics committee. The specific ethical number was 2017-977 and it was approved on November 30, 2019. The need for individual patient informed consent was waived.

Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Wang, GX., Ma, K., Pang, KJ. et al. Two approaches for newborns with critical congenital heart disease: a comparative study. World J Pediatr 18, 59–66 (2022). https://doi.org/10.1007/s12519-021-00482-5

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  • DOI: https://doi.org/10.1007/s12519-021-00482-5

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