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先天性心脏缺陷的产前诊断——一项基于人群的研究。

Prenatal diagnosis of congenital heart defects - a population based study.

作者信息

Nikkilä Annamari, Björkhem Gudrun, Källén Bengt

机构信息

Department of Obstetrics and Gynaecology, University Hospital Lund, Sweden.

出版信息

Acta Paediatr. 2007 Jan;96(1):49-52. doi: 10.1111/j.1651-2227.2006.00023.x.

Abstract

AIM

The aim of this study was to describe the efficiency of routine prenatal ultrasound screening for the detection of cardiac defects in a Swedish region and to study the effect of prenatal diagnosis on the survival and outcome of the child.

METHODS

We identified all fetuses and infants with a diagnosed major cardiac defect born in 1999-2003 in a region of Sweden using a register of the regional paediatric cardiac clinic, various health-care registers and registers of prenatally detected malformations. The outcome of newborns with and without a prenatal diagnosis of a cardiac defect was compared.

RESULTS

During the study period, 77,241 infants were born in the area. Among 145 major cardiac defects, 21% were detected prenatally. For the two university departments the detection rate was 38%. Of the major cardiac defects diagnosed <23 gestational weeks, 30% were terminated. No significant difference in the outcome was found between children with and without a prenatal diagnosis of a major cardiac defect.

CONCLUSIONS

It could not be shown that survival and outcome for children with major cardiac defects was better when the defect was known prenatally than if it was detected postnatally. The size of the study prohibits conclusions on moderate differences.

摘要

目的

本研究旨在描述瑞典某地区常规产前超声筛查对心脏缺陷的检测效率,并研究产前诊断对儿童生存及预后的影响。

方法

我们利用地区儿科心脏诊所登记册、各种医疗保健登记册以及产前检测出的畸形登记册,确定了1999 - 2003年在瑞典某地区出生的所有被诊断患有主要心脏缺陷的胎儿和婴儿。比较了有和没有产前心脏缺陷诊断的新生儿的预后情况。

结果

在研究期间,该地区有77241名婴儿出生。在145例主要心脏缺陷中,21%是产前检测出的。两个大学附属医院的检测率为38%。在妊娠<23周时诊断出的主要心脏缺陷中,30%被终止妊娠。产前诊断出主要心脏缺陷的儿童与未诊断出的儿童在预后方面未发现显著差异。

结论

无法证明产前已知主要心脏缺陷的儿童的生存及预后比出生后才检测出的儿童更好。本研究规模限制了关于微小差异的结论。

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