TY - JOUR
T1 - Fetal Diagnosis is Associated with Improved Perioperative Condition of Neonates Requiring Surgical Intervention for Coarctation
AU - Houshmandi, Mohammad Mehdi
AU - Eckersley, Luke
AU - Fruitman, Deborah
AU - Mills, Lindsay
AU - Power, Alyssa
AU - Hornberger, Lisa K.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/10
Y1 - 2021/10
N2 - To define the relative importance of fetal diagnosis and comorbidities in severity of preoperative compromise, outcomes and hospitalization in neonatal coarctation of the aorta (CoA). Retrospective comparison of preoperative condition and postoperative course of neonates prenatally (PreDx n = 48) or postnatally diagnosed (PostDx n = 67) with CoA. Congenital and non-congenital comorbidities were adjusted for. Postnatal diagnosis was associated with preoperative mortality (n = 2), and severe acidosis (lactate > 5 mM or pH < 7.20) on multivariate analysis (OR 4.2 (1.3–14.4, p = 0.02), with extracardiac congenital anomalies also a risk factor (OR 3.2 (1.03–10, p = 0.044). Median age at operation was delayed in the PostDx group (PreDx 6.5 days (IQR 4–9) vs PostDx 10 days (IQR 6–17)). Only comorbid left heart disease and extracardiac congenital anomalies were associated with prolonged total length of hospital stay. Prenatal diagnosis is the major adjustable risk factor affecting preoperative condition in critical CoA but does not reduce length of stay.
AB - To define the relative importance of fetal diagnosis and comorbidities in severity of preoperative compromise, outcomes and hospitalization in neonatal coarctation of the aorta (CoA). Retrospective comparison of preoperative condition and postoperative course of neonates prenatally (PreDx n = 48) or postnatally diagnosed (PostDx n = 67) with CoA. Congenital and non-congenital comorbidities were adjusted for. Postnatal diagnosis was associated with preoperative mortality (n = 2), and severe acidosis (lactate > 5 mM or pH < 7.20) on multivariate analysis (OR 4.2 (1.3–14.4, p = 0.02), with extracardiac congenital anomalies also a risk factor (OR 3.2 (1.03–10, p = 0.044). Median age at operation was delayed in the PostDx group (PreDx 6.5 days (IQR 4–9) vs PostDx 10 days (IQR 6–17)). Only comorbid left heart disease and extracardiac congenital anomalies were associated with prolonged total length of hospital stay. Prenatal diagnosis is the major adjustable risk factor affecting preoperative condition in critical CoA but does not reduce length of stay.
KW - Acidosis
KW - Coarctation of the aorta
KW - Fetal echocardiography
KW - Length of hospitalization
KW - Neonatal
KW - Perioperative outcome
KW - Preoperative
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U2 - 10.1007/s00246-021-02634-w
DO - 10.1007/s00246-021-02634-w
M3 - Article
C2 - 33988733
AN - SCOPUS:85105926706
SN - 0172-0643
VL - 42
SP - 1504
EP - 1511
JO - Pediatric Cardiology
JF - Pediatric Cardiology
IS - 7
ER -