Prenatal detection of congenital heart disease

J Pediatr. 2009 Jul;155(1):26-31, 31.e1. doi: 10.1016/j.jpeds.2009.01.050. Epub 2009 Apr 24.


Objectives: To define current frequency of prenatal detection of congenital heart disease (CHD), factors affecting prenatal detection, and its influence on postnatal course.

Study design: We prospectively identified all fetuses and infants < or =6 months of age with major CHD at 3 referral centers in Northern California over 1 year; we obtained prenatal and demographic data, reviewed prenatal ultrasound (US) and postnatal records, and used logistic regression to analyze maternal, fetal, and prenatal-care provider risk factors for prenatal diagnosis.

Results: Ninety-eight of 309 infants with major CHD had prenatal diagnosis (36% accounting for 27 pregnancy terminations); 185 infant-families participated in the postnatal survey, and although 99% had prenatal US, only 28% were prenatally diagnosed. Anomalous pulmonary venous return (0%), transposition of the great arteries (19%), and left obstructive lesions (23%) had the lowest prenatal detection. Heterotaxy (82%), single ventricle (64%), and HLHS (61%) had the highest. Prenatal diagnosis was higher at university versus community practices (P = .001). Sociodemographics were not associated with prenatal diagnosis. Infants diagnosed prenatally were less frequently ventilated (P < .01) or treated with prostaglandin (P < .05).

Conclusions: Prenatal detection of major CHD significantly alters postnatal course but remains low despite nearly universal US. CHD type and US practice type are important determinants of prenatal detection.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / epidemiology
  • Adult
  • California / epidemiology
  • Female
  • Heart Defects, Congenital / diagnosis*
  • Heart Defects, Congenital / epidemiology
  • Hospitals, Community
  • Hospitals, University
  • Humans
  • Infant
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Trimesters
  • Pregnancy, High-Risk
  • Prevalence
  • Prospective Studies
  • Prostaglandins / therapeutic use
  • Respiration, Artificial / statistics & numerical data
  • Risk Factors
  • Transportation of Patients / statistics & numerical data
  • Ultrasonography, Prenatal / statistics & numerical data*


  • Prostaglandins