262 - A morbidity and mortality comparison of children with univentricular congenital heart disease at one year of life with and without prenatal diagnosis

Poster Number: 262
Publication Number: 262.13

Silvia Andres, Childrens Garrahan Hospital, Buenos Aires, Buenos Aires, Argentina; Gisela Salas, Garrahan Pediatric Hospital, Ciudad Autonoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina; Maria Belen. Borgognoni, Hospital de Pediatria Juan P Garrahan, CABA, Ciudad Autonoma de Buenos Aires, Argentina; Tomas S. Alconada, Children's Hospital, La Plata, Buenos Aires, Argentina; Diana Fariña, HOSPITAL GARRAHAN, Caba, Ciudad Autonoma de Buenos Aires, Argentina

Background: The Congenital Heart Diseases (CHD) in Argentina, represent a 13% of infant mortality, after prematurity and infections rates. Only in 10% of the cases, they occur in pregnancies with identifiable risk factors. Prenatal diagnosis can reduce morbidity and mortality by coordinating and optimizing interdisciplinary perinatal care.

Objective: to compare the morbidity and mortality outcomes of children with univentricular congenital heart disease (UCHD) at one year of life, with and without prenatal diagnosis.

Design/Methods:

observational, prospective cohort study.

All the patients with diagnosis of UCHD admitted at the neonatal intensive care unit (NICU) of Garrahan Children’s Hospital from 2015 - 2020 were included in this study. Demographic and neonatal variables were analyzed. The primary outcome was the mortality rate at discharge; secondarily, we compared the extracardiac complications, the hospital stay, the growth, and the readmissions for acute respiratory infection rates at one year of life.

Results: 41 patients were analyzed (23 with prenatal diagnosis (PD) vs 18 without prenatal diagnosis (NPD)). There were no statistically significant differences regarding gestational age, birth weight, age at 1st surgery, hospitalization days, artificial ventilation, and parenteral nutrition therapy requirements. Significant differences were observed related to days of life at admission 4 (PD) vs 8 (NPD) days (p< 0.032); and cesarean delivery 78% vs 33% (p< 0.004), respectively. Between the two groups, the survival rate at discharge was 96% vs 78% (p< 0.083); and at one year of life was 74 % vs. 78% (p< 0.775), respectively. Growth Score Z (Ẋ±DS): birth weight: -0.11 ± 1.11; discharge weight: -1.82 ±1.45, weight at one year old: -0.65 ±1.25. Readmissions for acute respiratory infections were 24%.

Conclusion(s): in this cohort, only 56% had prenatal diagnosis. We did not observe a statistically significant difference in the mortality rate at discharge and at one year of life between both groups, probably due to the small number of cases and the severity of the univentricular condition. The nutritional impact during hospitalization was shown to be compensated at the first year of life. Although survival rate was high, these patients had multiple morbidities. Prenatal diagnosis benefited for an adequate counseling, intrauterine transport for third level management from birth.