Clinical and socioeconomic predictors of pregnancy termination for fetuses with congenital heart defects: a population‐based evaluation

Tararbit, Karim; Bui, Thi Thanh Thao; Lelong, Nathalie; Thieulin, Anne‐Claire; Goffinet, François; Khoshnood, Babak

doi:10.1002/pd.4043

Cited by 34 publications

(28 citation statements)

References 32 publications

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“…The severity of a cardiac anomaly and the presence of an associated co‐morbidity have also been identified as factors associated with pregnancy termination and stillbirth rates . In this study, the highest proportion of fetal deaths was recorded for Ebstein's anomaly (67%), followed by ToF (58%), TA (57%) and HLHS (55%).…”

Section: Discussionmentioning

confidence: 66%

Newborn pulse oximetry screening in the context of a high antenatal detection rate of critical congenital heart disease

et al. 2019

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Aim Assess the potential additional benefit from pulse oximetry screening in the early detection of critical congenital heart disease in a country with a well‐developed antenatal ultrasound screening programme. Methods Live‐born infants, pregnancy terminations and stillbirths from 20 weeks’ gestational age, between 2013 and 2015, with critical cardiac defects defined as primary or secondary targets of pulse oximetry screening were identified. Critical defects were those resulting in the death of a fetus or an infant in the first 28 days after birth, or a defect requiring intervention in the first 28 days. Results Two hundred and sixty‐eight infants and Fetuses were identified. Antenatal detection rates improved from 69% to 77% over the study period. An associated co‐morbidity improved antenatal detection rates. Twenty‐seven live‐born infants were diagnosed after discharge: 15 aortic arch obstruction (AAO); 10 d‐loop transposition of the great arteries (d‐TGA), and two total anomalous pulmonary venous drainage (TAPVD). Of these, five with AAO, nine with d‐TGA and likely both with TAPVD could potentially have been detected with oximetry screening. Conclusion The antenatal detection of critical cardiac anomalies continues to improve in New Zealand. Despite high antenatal detection rates for most lesions, universal postnatal oximetry screening has the potential to improve early detection.

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Section: Discussionmentioning

confidence: 66%

Newborn pulse oximetry screening in the context of a high antenatal detection rate of critical congenital heart disease

et al. 2019

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“…Although it is not clear what effect stillbirths or terminations might have on the observed results, data that show that terminations occur in <15% of pregnancies carrying a fetus with a CHD without a chromosomal defect and that <15% of all stillbirths have any kind of structural defect suggest that these factors likely would not alter the inferences made here to any significant degree. 35,36 Still, future studies that evaluate these patterns in pregnancies that result in termination or stillbirth would be useful, providing there is an opportunity for uniform ascertainment.…”

Section: Obstetrics Researchmentioning

confidence: 98%

Risk of critical congenital heart defects by nuchal translucency norms

Jelliffe‐Pawlowski

Norton

Shaw

et al. 2015

American Journal of Obstetrics and Gynecology

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“…This might occur when women are less likely to terminate pregnancies as a result of less frequent usage of prenatal diagnosis, lack of access to safe delivery facilities (e.g., poor women)[37], or cultural or religious practices[38–40]. …”

Section: Discussionmentioning

confidence: 99%

Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis

et al. 2016

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BackgroundWe conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in which pregnant women live and the risk of Congenital Heart Defects (CHDs), Neural Tube Defects (NTDs) and OroFacial Clefts (OFCs).MethodsWe searched MEDLINE from its inception to December 20th, 2015 for case-control, cohort and ecological studies assessing the association between neighborhood socioeconomic level and the risk of CHDs, NTDs and the specific phenotypes Cleft Lip with or without Cleft Palate (CLP) and Cleft Palate (CP). Study-specific risk estimates were pooled according to random-effect and fixed-effect models.ResultsOut of 245 references, a total of seven case-control studies, two cohort studies and two ecological studies were assessed in the systematic review; all studies were enrolled in the meta-analysis with the exception of the two cohort studies. No significant association has been revealed between CHDs or NTDs and neighborhood deprivation index. For CLP phenotype subgroups, we found a significantly higher rate in deprived neighborhoods (Odds Ratios (OR) = 1.22, 95% CI: 1.10, 1.36) whereas this was not significant for CP phenotype subgroups (OR = 1.20, 95%CI: 0.89, 1.61).ConclusionIn spite of the small number of epidemiological studies included in the present literature review, our findings suggest that neighborhood socioeconomic level where mothers live is associated only with an increased risk of CLP phenotype subgroups. This finding has methodological limitations that impede the formulation of firm conclusions, and further investigations should confirm this association.

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Clinical and socioeconomic predictors of pregnancy termination for fetuses with congenital heart defects: a population‐based evaluation

Abstract: In addition to severity of CHD, early prenatal diagnosis and maternal characteristics were highly associated with the probability of TOPFA for CHD.

Cited by 34 publications

References 32 publications

Newborn pulse oximetry screening in the context of a high antenatal detection rate of critical congenital heart disease

Newborn pulse oximetry screening in the context of a high antenatal detection rate of critical congenital heart disease

Risk of critical congenital heart defects by nuchal translucency norms

Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis

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