胎儿 CHD 与围产结局。
Fetal CHD and perinatal outcomes.
机构信息
Wayne State University School of Medicine, Detroit, MI, USA.
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
出版信息
Cardiol Young. 2020 May;30(5):686-691. doi: 10.1017/S1047951120000785. Epub 2020 Apr 20.
Abstract
OBJECTIVE
To evaluate delivery management and outcomes in fetuses prenatally diagnosed with CHD.
STUDY DESIGN
A retrospective cohort study was conducted on 6194 fetuses (born between 2013 and 2016), comparing prenatally diagnosed with CHD (170) to those with non-cardiac (234) and no anomalies (5790). Primary outcomes included the incidence of preterm delivery and mode of delivery.
RESULTS
Gestational age at delivery was significantly lower between the CHD and non-anomalous cohorts (38.6 and 39.1 weeks, respectively). Neonates with CHD had a significantly lower birth weights (p < 0.001). There was an approximately 1.5-fold increase in the rate of primary cesarean sections associated with prenatally diagnosed CHD with an odds ratio of 1.49 (95% CI 1.06-2.10).
CONCLUSIONS
Our study provides additional evidence that the prenatal diagnosis of CHD is associated with a lower birth weight, preterm delivery, and with an increased risk of delivery by primary cesarean section.
摘要
目的
评估胎儿先天性心脏病（CHD）产前诊断的分娩管理和结局。
研究设计
对 6194 例胎儿（2013 年至 2016 年出生）进行回顾性队列研究，将产前诊断为 CHD（170 例）与非心脏畸形（234 例）和无畸形（5790 例）胎儿进行比较。主要结局包括早产发生率和分娩方式。
结果
CHD 组和无畸形组的分娩孕周明显较低（分别为 38.6 周和 39.1 周）。患有 CHD 的新生儿出生体重明显较低（p < 0.001）。与产前诊断为 CHD 相关的初次剖宫产率约增加了 1.5 倍，优势比为 1.49（95%CI 1.06-2.10）。
结论
本研究进一步证明，产前诊断 CHD 与出生体重低、早产和初次剖宫产风险增加有关。
相似文献
1
Fetal CHD and perinatal outcomes.胎儿 CHD 与围产结局。
Cardiol Young. 2020 May;30(5):686-691. doi: 10.1017/S1047951120000785. Epub 2020 Apr 20.
2
Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.患有心脏异常的胎儿的新生儿结局及分娩方式的影响。
Am J Obstet Gynecol. 2017 Oct;217(4):469.e1-469.e12. doi: 10.1016/j.ajog.2017.05.049. Epub 2017 May 31.
3
The Effects of Turner Syndrome, 45,X on Obstetric and Neonatal Outcomes: A Retrospective Cohort Evaluation.特纳综合征（45,X）对产科和新生儿结局的影响：一项回顾性队列评估
Am J Perinatol. 2016 Oct;33(12):1152-8. doi: 10.1055/s-0036-1585083. Epub 2016 Jul 1.
4
Preterm Birth of Infants Prenatally Diagnosed with Congenital Heart Disease, Characteristics, Associations, and Outcomes.产前诊断为先天性心脏病的婴儿的早产、特征、关联因素及结局
Pediatr Cardiol. 2020 Jun;41(5):972-978. doi: 10.1007/s00246-020-02345-8. Epub 2020 Apr 30.
5
Neonatal and maternal outcomes of pregnancies with a fetal diagnosis of congenital heart disease using a standardized delivery room management protocol.使用标准化产房管理方案的胎儿先天性心脏病诊断的母婴结局。
J Perinatol. 2020 Feb;40(2):316-323. doi: 10.1038/s41372-019-0528-1. Epub 2019 Oct 14.
6
Timing and Mode of Delivery in Prenatally Diagnosed Congenital Heart Disease- an Analysis of Practices within the University of California Fetal Consortium (UCfC).产前诊断先天性心脏病的分娩时机与方式——加利福尼亚大学胎儿联盟（UCfC）内的实践分析
Pediatr Cardiol. 2017 Mar;38(3):588-595. doi: 10.1007/s00246-016-1552-y. Epub 2017 Jan 11.
7
Term cesarean delivery in the first pregnancy is not associated with an increased risk for preterm delivery in the subsequent pregnancy.首次妊娠行剖宫产术与随后妊娠的早产风险增加无关。
Am J Obstet Gynecol. 2019 Jul;221(1):61.e1-61.e7. doi: 10.1016/j.ajog.2019.02.036. Epub 2019 Feb 22.
8
[Appropriate delivery mode and timing of termination for pregnancy with low birth weight infants].[低出生体重儿妊娠的合适分娩方式及终止时机]
Zhonghua Fu Chan Ke Za Zhi. 2015 May;50(5):323-8.
9
The association between gestational age at delivery, closure type and perinatal outcomes in neonates with isolated gastroschisis.分娩时的胎龄、闭锁类型与单纯性先天性腹壁裂新生儿围生期结局的关系。
J Matern Fetal Neonatal Med. 2020 Apr;33(8):1393-1399. doi: 10.1080/14767058.2018.1519538. Epub 2018 Oct 1.
10
Previous cesarean delivery associated with subsequent preterm birth in the United States.在美国，既往剖宫产与随后的早产相关。
Eur J Obstet Gynecol Reprod Biol. 2018 Oct;229:88-93. doi: 10.1016/j.ejogrb.2018.08.013. Epub 2018 Aug 11.
引用本文的文献
1
Uric Acid Disrupts Heart Development in Zebrafish by Inhibiting the Wnt Signaling Pathway.尿酸通过抑制Wnt信号通路破坏斑马鱼的心脏发育。
Cardiovasc Toxicol. 2025 Aug 21. doi: 10.1007/s12012-025-10053-z.
2
Epidemiological characteristics and trends based on a joinpoint regression model of preterm birth with congenital heart disease in Changsha City, China, from 2011 to 2023.基于连接点回归模型的2011年至2023年中国长沙市早产合并先天性心脏病的流行病学特征及趋势
Transl Pediatr. 2025 Mar 31;14(3):382-390. doi: 10.21037/tp-24-411. Epub 2025 Mar 26.
3
Prenatal diagnosis of fetal defects and its implications on the delivery mode.胎儿缺陷的产前诊断及其对分娩方式的影响。
Open Med (Wars). 2023 May 12;18(1):20230704. doi: 10.1515/med-2023-0704. eCollection 2023.
4
Practice variations for fetal and neonatal congenital heart disease within the Children's Hospitals Neonatal Consortium.儿童医院新生儿联盟中胎儿和新生儿先天性心脏病的实践差异。
Pediatr Res. 2023 May;93(6):1728-1735. doi: 10.1038/s41390-022-02314-2. Epub 2022 Sep 27.
5
Fetal congenital heart disease - mode of delivery and obstetrical complications.胎儿先天性心脏病 - 分娩方式和产科并发症。
BMC Pregnancy Childbirth. 2022 Jul 19;22(1):578. doi: 10.1186/s12884-022-04910-w.
本文引用的文献
1
ACOG Committee Opinion No. 765: Avoidance of Nonmedically Indicated Early-Term Deliveries and Associated Neonatal Morbidities.美国妇产科医师学会委员会意见 No.765：避免无医学指征的早期早产及其相关新生儿并发症。
Obstet Gynecol. 2019 Feb;133(2):e156-e163. doi: 10.1097/AOG.0000000000003076.
2
ACOG Committee Opinion No. 764: Medically Indicated Late-Preterm and Early-Term Deliveries.美国妇产科医师学会委员会意见 No.764：医学指征的晚期早产儿和早期足月产儿分娩。
Obstet Gynecol. 2019 Feb;133(2):e151-e155. doi: 10.1097/AOG.0000000000003083.
3
Impact of prenatal diagnosis on survival of newborns with four congenital heart defects: a prospective, population-based cohort study in France (the EPICARD Study).产前诊断对四种先天性心脏病新生儿存活率的影响：法国一项前瞻性、基于人群的队列研究（EPICARD 研究）。
BMJ Open. 2017 Nov 8;7(11):e018285. doi: 10.1136/bmjopen-2017-018285.
4
Survival, by Birth Weight and Gestational Age, in Individuals With Congenital Heart Disease: A Population-Based Study.先天性心脏病患者按出生体重和孕周划分的生存率：一项基于人群的研究
J Am Heart Assoc. 2017 Jul 21;6(7):e005213. doi: 10.1161/JAHA.116.005213.
5
Timing and Mode of Delivery in Prenatally Diagnosed Congenital Heart Disease- an Analysis of Practices within the University of California Fetal Consortium (UCfC).产前诊断先天性心脏病的分娩时机与方式——加利福尼亚大学胎儿联盟（UCfC）内的实践分析
Pediatr Cardiol. 2017 Mar;38(3):588-595. doi: 10.1007/s00246-016-1552-y. Epub 2017 Jan 11.
6
Congenital Heart Defects and Indices of Placental and Fetal Growth in a Nationwide Study of 924 422 Liveborn Infants.先天性心脏病与胎盘和胎儿生长指数：全国 924422 例活产儿的研究
Circulation. 2016 Nov 15;134(20):1546-1556. doi: 10.1161/CIRCULATIONAHA.116.021793. Epub 2016 Oct 14.
7
Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation.左心发育不全综合征与胎盘结构和血管异常以及瘦素调节异常有关。
Placenta. 2015 Oct;36(10):1078-86. doi: 10.1016/j.placenta.2015.08.003. Epub 2015 Aug 7.
8
Prenatal diagnosis of critical congenital heart disease reduces risk of death from cardiovascular compromise prior to planned neonatal cardiac surgery: a meta-analysis.严重先天性心脏病的产前诊断可降低计划进行新生儿心脏手术前因心血管功能不全导致的死亡风险：一项荟萃分析。
Ultrasound Obstet Gynecol. 2015 Jun;45(6):631-8. doi: 10.1002/uog.14882.
9
Gestational age at birth and outcomes after neonatal cardiac surgery: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.出生时的孕周与新生儿心脏手术后的结局：胸外科医师协会先天性心脏病手术数据库分析
Circulation. 2014 Jun 17;129(24):2511-7. doi: 10.1161/CIRCULATIONAHA.113.005864. Epub 2014 May 2.
10
United States birth weight reference corrected for implausible gestational age estimates.美国出生体重参考值，对不可信的孕龄估计进行了修正。
Pediatrics. 2014 May;133(5):844-53. doi: 10.1542/peds.2013-3285.
Zotero 插件