Goldberg, David

Hill, Kevin

Huhta, James

Jacobs, Jeffrey

Jacobs, Marshall

Kim, Sung Hee

Pasquali, Sara

Quartermain, Michael D.

Ungerleider, Ross

Elsevier - Publisher Connector 

A497
JACC April 1, 2014
Volume 63, Issue 12
Congenital Heart Disease
natiOnal VariatiOn in Prenatal DiagnOsis Of cOngenital heart Disease by state anD 
lesiOn tyPe: an analysis Of the sOciety Of thOracic surgeOns cOngenital heart surgery 
(sts-chs) Database
Oral Contributions
Room 144 B
Sunday, March 30, 2014, 11:30 p.m.-11:45 p.m.
Session Title: Congenital Heart Disease Year in Review
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 922-06
Authors: Michael D. Quartermain, Sara Pasquali, Kevin Hill, David Goldberg, James Huhta, Jeffrey Jacobs, Marshall Jacobs, Sung Hee Kim, Ross 
Ungerleider, Wake Forest University School of Medicine, Winston-Salem, NC, USA
background: Prenatal diagnosis allows for improved peri-operative outcomes of fetuses with certain forms of congenital heart disease (CHD). 
Variability in prenatal diagnosis has been demonstrated in other countries, leading to efforts to improve access to care and fetal imaging protocols, 
but has not been examined across the US. We evaluated national variation in prenatal diagnosis across geographic region and lesion type in 
neonates with CHD undergoing heart surgery.
methods: Neonates (≤30d) undergoing heart surgery in the STS-CHS Database (2006-12) were included. Centers with >15% missing prenatal 
diagnosis data were excluded. Rates of prenatal diagnosis were compared across geographic location of residence and lesion type using the Chi-
square test.
results: Overall, 18,631 neonates from 44 states operated on at 91 US centers were included. Prenatal diagnosis occurred in 42% and increased 
every year from 33% (2006) to 49% (2012). There was significant geographic variation in rates of prenatal diagnosis (range 23%-61% across states, 
p < 0.001). Significant variability by lesion type was also observed (figure); with higher rates for lesions identifiable on 4-chamber view versus those 
requiring outflow tract visualization (39% versus 20%, p < 0.0001).
conclusions: Rates of prenatal CHD diagnosis in the US remain low, with significant variability between states and across lesion type. Further 
studies are needed to better define reasons for this variation and the potential impact on patient outcomes.
 


NATIONAL VARIATION IN PRENATAL DIAGNOSIS OF CONGENITAL HEART DISEASE BY STATE AND LESION TYPE: AN ANALYSIS OF THE SOCIETY OF THORACIC SURGEONS CONGENITAL HEART SURGERY (STS-CHS) DATABASE 

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NATIONAL VARIATION IN PRENATAL DIAGNOSIS OF CONGENITAL HEART DISEASE BY STATE AND LESION TYPE: AN ANALYSIS OF THE SOCIETY OF THORACIC SURGEONS CONGENITAL HEART SURGERY (STS-CHS) DATABASE

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