Open Access

ARTICLE

The Effect of Prenatal Diagnosis of Critical Congenital Heart Disease on Postnatal Mortality and Morbidity: A Retrospective Cohort Study

Aygül Kaya Akıllı¹, Osman Akdeniz², Celal Özcan^3,*

1 Department of Pediatrics, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
2 Department of Pediatric Cardiology, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
3 Department of Pediatric Allergy and Immunology, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey

* Corresponding Author: Celal Özcan. Email:

(This article belongs to the Special Issue: Prenatal Diagnosis of Congenital Heart Disease)

Structural and Congenital Heart Disease 2026, 21(2), 4 https://doi.org/10.32604/schd.2026.076628

Received 24 November 2025; Accepted 04 June 2026; Issue published 11 June 2026

Abstract

Background: Congenital heart disease (CHD) refers to malformations of the heart or great vessels that occur during the intrauterine period. Critical CHD refers to heart conditions that require medical intervention or surgical procedures in the early stages of life. Methods: In this retrospective cohort study, newborns aged 0 to 28 days who were admitted to the Neonatal Intensive Care Unit and the Pediatric Cardiovascular Surgery Clinic of our hospital with a diagnosis of critical CHD between January 2019 and September 2024 were evaluated. Results: Among 160 patients, 52 (32.5%) had a prenatal diagnosis. Overall mortality was significantly higher in the prenatally diagnosed group compared to the postnatally diagnosed group (51.9% vs. 19.5%, p < 0.001). However, in the subgroup of patients with hypoplastic left heart syndrome (HLHS), pulmonary atresia (PA), or aortic arch anomalies (n = 67), prenatal diagnosis was associated with significantly lower mortality (38.9% vs. 68.8%, p = 0.018). Multivariate logistic regression identified prenatal diagnosis (OR 3.11, 95% CI 1.37–7.06), presence of the above high-risk lesions (OR 3.29, 95% CI 1.25–8.67), and lower birth weight (per 1 kg, OR 2.09, 95% CI 1.13–3.88) as independent predictors of mortality. Conclusions: In this cohort, the overall higher mortality among prenatally diagnosed patients reflects a higher proportion of complex lesions (e.g., HLHS) in that group. Nevertheless, within the high-risk subgroup of HLHS, PA, and aortic arch anomalies, prenatal diagnosis was associated with a significant survival benefit. These findings suggest that the impact of prenatal diagnosis on mortality is lesion-specific and confounded by disease severity. Future multicenter prospective studies with larger, homogeneous populations are needed to clarify the true effect of prenatal diagnosis on outcomes.

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