A population-based study of the association of prenatal diagnosis with survival rate for infants with congenital heart defects.
A population-based study of the association of prenatal diagnosis with survival rate for infants with congenital heart defects.
复制标题
对先天性心脏缺陷的婴儿的产前诊断与存活率关联的基于人群的研究。
DOI：
10.1016/j.amjcard.2013.11.066
复制
发表时间：
2014-03-15
影响因子：
2.8
通讯作者：
Correa, Adolfo
中科院分区：
文献类型：
--
作者：
Oster, Matthew E.;Kim, Christopher H.;Kusano, Aaron S.;Cragan, Janet D.;Dressler, Paul;Hales, Alice R.;Mahle, William T.;Correa, Adolfo
产前诊断已被证明可以改善先天性心脏病（CHD）新生儿的术前发病率，但与死亡率的相关性存在相互矛盾的数据。我们对1994年至2005年期间出生前和出生后诊断为先天性心脏病的婴儿进行了一项基于人群的回顾性队列研究，该研究由亚特兰大大都会先天性缺陷项目确定。在孤立性CHD的婴儿中，我们估计了产前与产后诊断的1年Kaplan-Meier生存概率，并估计了校正了严重CHD状态、胎龄和母亲种族/民族的考克斯比例风险比。在539，519名活产婴儿中，4，348名婴儿患有CHD（411名产前诊断）。与非严重缺陷的患者相比，严重缺陷的患者更容易在产前诊断（分别为58%和20%，p <0.001）。在3,146名患有先天性心脏病的婴儿中，产前诊断的1年生存率为77%（n = 207），而出生后诊断的1年生存率为96%（n = 2,939，p <0.001）。比较仅患有非危重CHD的患者（n = 2，455）的1年生存率，产前和产后诊断之间没有差异（分别为96%和98%，p = 0.26），而在患有危重CHD的患者（n = 691）中，产前诊断的婴儿的生存率显着较低（分别为71%和86%，p <0.001）。在危重CHD婴儿中，产前诊断与产后诊断（参考）1年死亡率的校正风险比为2.51（95%置信区间1.72至3.66）。总之，产前诊断与孤立性危重CHD婴儿的1年生存率较低相关，但与孤立性非危重CHD婴儿的1年生存率无相关性。在产前诊断的关键CHD亚型中，更严重的疾病可能解释这些发现。
Prenatal diagnosis has been shown to improve preoperative morbidity in newborns with congenital heart defects (CHDs), but there are conflicting data as to the association with mortality. We performed a population-based, retrospective, cohort study of infants with prenatally versus postnatally diagnosed CHDs from 1994 to 2005 as ascertained by the Metropolitan Atlanta Congenital Defects Program. Among infants with isolated CHDs, we estimated 1-year Kaplan-Meier survival probabilities for prenatal versus postnatal diagnosis and estimated Cox proportional hazard ratios adjusted for critical CHD status, gestational age, and maternal race/ethnicity. Of 539,519 live births, 4,348 infants had CHDs (411 prenatally diagnosed). Compared with those with noncritical defects, those with critical defects were more likely to be prenatally diagnosed (58% vs 20%, respectively, p <0.001). Of the 3,146 infants with isolated CHDs, 1-year survival rate was 77% for those prenatally diagnosed (n = 207) versus 96% for those postnatally diagnosed (n = 2,939, p <0.001). Comparing 1-year survival rate among those with noncritical CHDs alone (n = 2,455) showed no difference between prenatal and postnatal diagnoses (96% vs 98%, respectively, p = 0.26), whereas among those with critical CHDs (n = 691), prenatally diagnosed infants had significantly lower survival rate (71% vs 86%, respectively, p <0.001). Among infants with critical CHDs, the adjusted hazard ratio for 1-year mortality rate for those prenatally versus postnatally (reference) diagnosed was 2.51 (95% confidence interval 1.72 to 3.66). In conclusion, prenatal diagnosis is associated with lower 1-year survival rate for infants with isolated critical CHDs but shows no change for those with isolated noncritical CHDs. More severe disease among the critical CHD subtypes diagnosed prenatally might explain these findings.
登录
查看更多内容
影响因子：
1.6
作者：
Landis, Benjamin J.;Levey, Allison;Williams, Ismee A.
通讯作者：
Williams, Ismee A.
DOI：
10.1016/s0735-1097(96)00381-6
发表时间：
1996-12-01
影响因子：
24
作者：
Montana, E;Khoury, MJ;Fyfe, D
通讯作者：
Fyfe, D
影响因子：
1
作者：
Strickland MJ;Riehle-Colarusso TJ;Jacobs JP;Reller MD;Mahle WT;Botto LD;Tolbert PE;Jacobs ML;Lacour-Gayet FG;Tchervenkov CI;Mavroudis C;Correa A
通讯作者：
Correa A
影响因子：
1.3
作者：
Gedikbasi, Ali;Oztarhan, Kazim;Ceylan, Yavuz
通讯作者：
Ceylan, Yavuz
影响因子：
1.6
作者：
Levey, Allison;Glickstein, Julie S.;Williams, Ismee A.
通讯作者：
Williams, Ismee A.