Prenatal diagnosis of significant congenital heart disease and elective termination of pregnancy in Nevada

Abstract

Objective

We investigated the relationship between prenatal detection of significant congenital heart disease and elective termination of pregnancy over time in Nevada.

Methods

We identified those prenatally or post-natally diagnosed with significant congenital cardiovascular malformations in Nevada with birth dates or estimated delivery dates between July 2012 and June 2021.

Results

We identified 1246. Of 1246, 69 underwent fetal demise, 42 had elective termination, and 1135 were live-born. Of the 1135 live-born, 1090 had prenatal care, of which 718 (66%) overall had a prenatal diagnosis of significant congenital heart disease. However, prenatal detection statistically significantly increased over time from 45 to 82%, p = .00001. Termination of pregnancy averaged 10% of those identified within the legal timeframe, and the rate did not statistically significantly increase with increasing prenatal detection rates, p = .56. Of the 42 undergoing elective termination, 23 (55%) had syndromes or comorbidities vs. 280 (25%) of the 1135 live-births, p = .0003.

Conclusions

In Nevada, despite a statistically significant increase in prenatal detection of significant congenital heart disease over time, termination of pregnancy rates did not increase. Nevertheless, those undergoing elective termination were more likely to have associated syndromes or comorbidities.

Keywords:

• Congenital heart disease
• prenatal detection
• termination of pregnancy
• fetal echocardiography
• syndromes
• fetal comorbidities

Acknowledgments

This work would not be possible without the contributions of many. The authors first thank the perinatologists and the perinatal sonographers at the following Nevada maternal-fetal-medicine programs: Desert Perinatal Associates in Las Vegas, High Risk Pregnancy Center in Las Vegas and Reno, Perinatology Associates of Northern Nevada in Reno, University of Nevada Las Vegas Perinatology in Las Vegas. Finally, we thank all the fetal cardiologists in Las Vegas and Reno at the Children’s Heart Center Nevada.

Disclosure statement

The authors declared that there is no conflict of interest.