TY  - EJOU
AU  - Akıllı, Aygül Kaya 
AU  - Akdeniz, Osman 
AU  - Özcan, Celal 

TI  - The Effect of Prenatal Diagnosis of Critical Congenital Heart Disease on Postnatal Mortality and Morbidity: A Retrospective Cohort Study
T2  - Structural and Congenital Heart Disease

PY  - 2026
VL  - 21
IS  - 2
SN  - 3071-1738

AB  - <b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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%, <i>p</i> < 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%, <i>p</i> = 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. <b>Conclusions:</b> 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.
KW  - Congenital heart disease; prenatal diagnosis; fetal echocardiography

DO  - 10.32604/schd.2026.076628