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Multicenter Study
. 2023 Mar;43(3):378-384.
doi: 10.1038/s41372-022-01571-7. Epub 2022 Dec 20.

Prenatal care coordination, racial and socioeconomic inequities, and pre- and post-operative outcomes in hypoplastic left heart syndrome

David N Schidlow  1 , Kimberlee Gauvreau  2 , Emily M Bucholz  2 , Amy Bennett  3 , Terra Lafranchi  2 , Jay Pruetz  4 , Christina Ronai  2 , Jeffrey Vergales  5 , David W Brown  2
Affiliations
Multicenter Study

Prenatal care coordination, racial and socioeconomic inequities, and pre- and post-operative outcomes in hypoplastic left heart syndrome

David N Schidlow et al. J Perinatol. 2023 Mar.

Abstract

Objective: We sought to identify associations between prenatal care coordination (PNC) and outcomes in hypoplastic left heart syndrome (HLHS).

Study design: We hypothesized that suboptimal PNC is associated with worse pre-operative status. HLHS patients from 2016 through 2019 were identified using a multicenter registry. Optimal PNC was defined as (1) a completed interdisciplinary conference and (2) closed-loop communication with the obstetric team. Associations between PNC and outcomes were identified.

Results: Of 1441 patients, 1242 (86%) had prenatal diagnosis. Among those with a prenatal diagnosis, PNC was achieved in only 845 (68%). Suboptimal PNC was associated with adverse events (50% vs 40%, p < 0.001), inotrope need (19% vs 13%, p = 0.007), mechanical ventilation (22% vs 16%, p = 0.016), and parenteral feeding (60% vs 46%, p < 0.001). African-American race and non-commercial insurance were associated with a lower likelihood of optimal PNC (p = 0.006 and p < 0.001, respectively).

Conclusion: Improving PNC and overcoming racial and socioeconomic barriers are important targets to improve HLHS perinatal care.

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References

    1. Donofrio MT, Levy RJ, Schuette JJ, Skurow-Todd K, Sten M-BB, Stallings C, et al. Specialized delivery room planning for fetuses with critical congenital heart disease. Am J Cardiol. 2013;111:737–47. - DOI - PubMed
    1. Brown DW, Cohen KE, O’Brien P, Gauvreau K, Klitzner TS, Beekman RH, et al. Impact of prenatal diagnosis in survivors of initial palliation of single ventricle heart disease: analysis of the national pediatric cardiology quality improvement collaborative database. Pediatr Cardiol. 2014;36:314–21. - DOI - PubMed
    1. Kumar RK, Newburger JW, Gauvreau K, Kamenir SA, Hornberger LK. Comparison of outcome when hypoplastic left heart syndrome and transposition of the great arteries are diagnosed prenatally versus when diagnosis of these two conditions is made only postnatally. Am J Cardiol. 1999;83:1649–53. - DOI - PubMed
    1. Rychik J, Donaghue DD, Levy S, Fajardo C, Combs J, Zhang X, et al. Maternal psychological stress after prenatal diagnosis of congenital heart disease. J Pediatr. 2013;162:302–307.e1. - DOI - PubMed
    1. Sanapo L, Pruetz JD, Słodki M, Goens MB, Moon-Grady AJ, Donofrio MT. Fetal echocardiography for planning perinatal and delivery room care of neonates with congenital heart disease. Echocardiography. 2017;34:1804–21. - DOI - PubMed

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