Carhuayo-Chura Julissa, Terpin-Ayvar Felipe E, Bautista-Pariona Anthony, Zila-Velasque J Pierre, Velarde-Zegarra Luis S, Davila-Aliaga Carmen, Bravo-Jaimes Katia
School of Medicine, Universidad Ricardo Palma, Lima, Peru.
School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
JACC Adv. 2025 Jun;4(6 Pt 1):101775. doi: 10.1016/j.jacadv.2025.101775. Epub 2025 May 12.
Critical congenital heart disease (CCHD) affects 1 in 400 newborns and requires early intervention to prevent neonatal mortality. In Peru, neonatal CCHD screening is primarily implemented in the capital, but its impact on patient outcomes remains unclear.
The purpose of this study was to evaluate the short-term outcomes of an early CCHD-detection program at the National Maternal Perinatal Institute in Lima, Peru.
A retrospective cohort study included all newborns diagnosed with CCHD at National Maternal Perinatal Institute between January 2022 and December 2023. Data were extracted from medical records, including maternal demographics, neonatal characteristics, and referral times to the 2 existing surgical congenital heart disease centers in Lima. Survival status was assessed through national identification registry records. Time to transfer, delays, and survival rates were analyzed using descriptive statistics, Kaplan-Meier survival curves, and multivariable models.
A total of 34 neonates were diagnosed with CCHD. The most common conditions were hypoplastic left heart syndrome (18%) and pulmonary atresia (18%). Median time from birth to transfer was 8 days for EsSalud and 16 days for Ministry of Health (MINSA) surgical centers. The main causes of delay were lack of bed availability and administrative barriers. One-year survival rates were 36.7% for MINSA referrals and 85.7% for EsSalud referrals.
Despite early CCHD detection, neonatal mortality remains high, particularly for patients referred to MINSA centers. These findings highlight the urgent need to optimize referral pathways and expand surgical capacity to improve survival outcomes.
重症先天性心脏病（CCHD）影响着每400名新生儿中的1名，需要早期干预以预防新生儿死亡。在秘鲁，新生儿CCHD筛查主要在首都实施，但其对患者预后的影响仍不明确。
本研究的目的是评估秘鲁利马国家母婴围产期研究所早期CCHD检测项目的短期结果。
一项回顾性队列研究纳入了2022年1月至2023年12月期间在国家母婴围产期研究所被诊断为CCHD的所有新生儿。数据从医疗记录中提取，包括产妇人口统计学、新生儿特征以及转诊至利马现有的2个先天性心脏病外科中心的时间。通过国家身份登记记录评估生存状况。使用描述性统计、Kaplan-Meier生存曲线和多变量模型分析转诊时间、延误情况和生存率。
共有34名新生儿被诊断为CCHD。最常见的病症是左心发育不全综合征（18%）和肺动脉闭锁（18%）。对于EsSalud外科中心，从出生到转诊的中位时间为8天，对于卫生部（MINSA）外科中心为16天。延误的主要原因是床位不足和行政障碍。MINSA转诊患者的一年生存率为36.7%，EsSalud转诊患者为85.7%。
尽管早期检测出CCHD，但新生儿死亡率仍然很高，尤其是对于转诊至MINSA中心的患者。这些发现凸显了优化转诊途径和扩大手术能力以改善生存结局的迫切需求。
