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COVID-19 大流行前后产前检测严重先天性心脏病的检出率更新。

Update on Prenatal Detection Rate of Critical Congenital Heart Disease Before and During the COVID-19 Pandemic.

机构信息

Children's Hospital Los Angeles, Department of Pediatrics, Los Angeles, California, USA.

Keck School of Medicine of USC, Los Angeles, California, USA.

出版信息

Pediatr Cardiol. 2024 Jun;45(5):1015-1022. doi: 10.1007/s00246-024-03487-9. Epub 2024 Apr 3.

Abstract

Prenatal diagnosis of critical congenital heart disease (CCHD) has improved over time, and previous studies have identified CCHD subtype and socioeconomic status as factors influencing rates of prenatal diagnosis. Our objective of this single-center study was to compare prenatal diagnosis rates of newborns with CCHD admitted for cardiac intervention from the COVID-19 pandemic period (March 2020 to March 2021) to the pre-pandemic period and identify factors associated with the lack of CCHD prenatal diagnosis. The overall rate of CCHD and rates of the various CCHD diagnoses were calculated and compared with historical data collection periods (2009-2012 and 2013-2016). Compared with the 2009-2012 pre-pandemic period, patients had 2.17 times higher odds of having a prenatal diagnosis of CCHD during the pandemic period controlling for lesion type (aOR = 2.17, 95% CI 1.36-3.48, p = 0.001). Single ventricle lesions (aOR 6.74 [4.64-9.80], p < 0.001) and outflow tract anomalies (aOR 2.20 [1.56-3.12], p < 0.001) had the highest odds of prenatal diagnosis compared with the remaining lesions. Patients with outflow tract anomalies had higher odds for prenatal detection in the pandemic period compared with during the 2009-2012 pre-pandemic period (aOR 2.01 [1.06-3.78], p = 0.031). In conclusion, prenatal detection of CCHD among newborns presenting for cardiac intervention appeared to have improved during the pandemic period.

摘要

先天性心脏病(CCHD)的产前诊断技术不断提高,既往研究表明,CCHD 亚型和社会经济地位是影响产前诊断率的因素。本单中心研究的目的是比较 2020 年 3 月至 2021 年 3 月 COVID-19 大流行期间与大流行前时期接受心脏介入治疗的新生儿 CCHD 的产前诊断率,并确定与 CCHD 产前漏诊相关的因素。计算了 CCHD 的总体发生率和各种 CCHD 诊断的发生率,并与历史数据采集时期(2009-2012 年和 2013-2016 年)进行了比较。与 2009-2012 年大流行前时期相比,在控制病变类型的情况下,大流行期间 CCHD 的产前诊断率增加了 2.17 倍(调整后的优势比[aOR] = 2.17,95%置信区间[CI]1.36-3.48,p = 0.001)。与其他病变相比,单心室病变(aOR 6.74[4.64-9.80],p < 0.001)和流出道异常(aOR 2.20[1.56-3.12],p < 0.001)的产前诊断率最高。与 2009-2012 年大流行前时期相比,流出道异常的患儿在大流行期间产前检测的几率更高(aOR 2.01[1.06-3.78],p = 0.031)。总之,在 COVID-19 大流行期间,接受心脏介入治疗的新生儿的 CCHD 产前检出率似乎有所提高。

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