Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study
Background Fetal echocardiography is the mainstay of prenatal diagnosis of congenital heart disease. The COVID‐19 pandemic led to shifts in triage of prenatal services. Our objective was to evaluate the impact of COVID‐19 restrictions on prenatal diagnosis, surgical outcomes, and disparities in neon...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-05-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037079 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850271125883322368 |
|---|---|
| author | Bhawna Arya Miza Salim Hammoud Andrew J. Toth Joyce Woo Matthew Campbell Angira Patel Lindsay A. Edwards Lindsay Freud Rupali Gandhi Anita Krishnan Shabnam Peyvandi Nelangi Pinto Christina Ronai Kristen Sexson Tejtel Anita Moon‐Grady Mary T. Donofrio Shubhika Srivastava Tara Karamlou |
| author_facet | Bhawna Arya Miza Salim Hammoud Andrew J. Toth Joyce Woo Matthew Campbell Angira Patel Lindsay A. Edwards Lindsay Freud Rupali Gandhi Anita Krishnan Shabnam Peyvandi Nelangi Pinto Christina Ronai Kristen Sexson Tejtel Anita Moon‐Grady Mary T. Donofrio Shubhika Srivastava Tara Karamlou |
| author_sort | Bhawna Arya |
| collection | DOAJ |
| description | Background Fetal echocardiography is the mainstay of prenatal diagnosis of congenital heart disease. The COVID‐19 pandemic led to shifts in triage of prenatal services. Our objective was to evaluate the impact of COVID‐19 restrictions on prenatal diagnosis, surgical outcomes, and disparities in neonatal critical congenital heart disease (CCHD) management in the United States during the pandemic's first year. Methods and Results A multi‐institutional retrospective cohort study compared neonatal CCHD outcomes (requiring surgery within 60 days of birth) 1 year prior (prepandemic era) and during the peak pandemic era, supplemented by a Fetal Heart Society survey assessing regional practice changes. Data on prenatal diagnosis, demographics, outcomes, and 2020 state Area Deprivation Index were analyzed using Wilcoxon rank sum and χ2 tests. The survey, completed by 72 fetal cardiologists from 9 US census regions, showed 75% of institutions implemented restrictions by March 2020, affecting triage, referrals, and number of prenatal cardiology visits. Compared with CCHD neonates born prepandemic (n=4637), those born during the pandemic (n=1806) had a higher proportion of prenatal diagnosis (66% versus 63%, P<0.05). There were no significant differences in complications or mortality, but pandemic‐era neonates had longer hospital stays. During the pandemic, CCHD neonates had a more disadvantaged Area Deprivation Index and had surgery at hospitals located in more advantaged regions. Conclusions Although pandemic‐driven care delivery adjustments affected perinatal cardiology referrals and triage, prenatal diagnosis, perioperative outcomes, and survival remained robust. The management of CCHD demonstrates health care resilience, maintaining core prenatal and perioperative care. Regional variations highlight the need for targeted strategies to address disparities during health care crises. |
| format | Article |
| id | doaj-art-521a39f08208490c8db88bc03143cdf8 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-521a39f08208490c8db88bc03143cdf82025-08-20T01:52:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-05-0114910.1161/JAHA.124.037079Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative StudyBhawna Arya0Miza Salim Hammoud1Andrew J. Toth2Joyce Woo3Matthew Campbell4Angira Patel5Lindsay A. Edwards6Lindsay Freud7Rupali Gandhi8Anita Krishnan9Shabnam Peyvandi10Nelangi Pinto11Christina Ronai12Kristen Sexson Tejtel13Anita Moon‐Grady14Mary T. Donofrio15Shubhika Srivastava16Tara Karamlou17Department of Pediatrics Seattle Children’s Hospital and the University of Washington School of Medicine Seattle WA USADivision of Pediatric Cardiac Surgery, Heart, Vascular & Thoracic Institute Cleveland Clinic Cleveland OH USADepartment of Quantitative Health Sciences Cleveland Clinic Cleveland OH USADivision of Cardiology Ann & Robert H. Lurie Children Hospital of Chicago and Northwestern University Feinberg School of Medicine Chicago IL USADepartment of Pediatrics Texas Children’s Hospital, Baylor College of Medicine Houston TX USADivision of Cardiology Ann & Robert H. Lurie Children Hospital of Chicago and Northwestern University Feinberg School of Medicine Chicago IL USADepartment of Pediatrics, Division of Pediatric Cardiology Duke University School of Medicine Durham NC USADivision of Cardiology, The Hospital for Sick Children University of Toronto Toronto CanadaDivision of Cardiology, Advocate Children’s Hospital Oak Lawn IL USADivision of Cardiology, Children’s National Hospital George Washington University School of Medicine, and Health Sciences Washington DC USADepartment of Pediatrics University of California San Francisco CA USADepartment of Pediatrics Seattle Children’s Hospital and the University of Washington School of Medicine Seattle WA USADepartment of Cardiology, Boston Children’s Hospital, Department of Pediatrics Harvard Medical School Boston MA USADepartment of Pediatrics Texas Children’s Hospital, Baylor College of Medicine Houston TX USADepartment of Pediatrics University of California San Francisco CA USADivision of Cardiology, Children’s National Hospital George Washington University School of Medicine, and Health Sciences Washington DC USADepartment of Cardiovascular Services Center for Cardiovascular Research and Innovation Nemours Children’s Health Wilmington DE USADivision of Pediatric Cardiac Surgery, Heart, Vascular & Thoracic Institute Cleveland Clinic Cleveland OH USABackground Fetal echocardiography is the mainstay of prenatal diagnosis of congenital heart disease. The COVID‐19 pandemic led to shifts in triage of prenatal services. Our objective was to evaluate the impact of COVID‐19 restrictions on prenatal diagnosis, surgical outcomes, and disparities in neonatal critical congenital heart disease (CCHD) management in the United States during the pandemic's first year. Methods and Results A multi‐institutional retrospective cohort study compared neonatal CCHD outcomes (requiring surgery within 60 days of birth) 1 year prior (prepandemic era) and during the peak pandemic era, supplemented by a Fetal Heart Society survey assessing regional practice changes. Data on prenatal diagnosis, demographics, outcomes, and 2020 state Area Deprivation Index were analyzed using Wilcoxon rank sum and χ2 tests. The survey, completed by 72 fetal cardiologists from 9 US census regions, showed 75% of institutions implemented restrictions by March 2020, affecting triage, referrals, and number of prenatal cardiology visits. Compared with CCHD neonates born prepandemic (n=4637), those born during the pandemic (n=1806) had a higher proportion of prenatal diagnosis (66% versus 63%, P<0.05). There were no significant differences in complications or mortality, but pandemic‐era neonates had longer hospital stays. During the pandemic, CCHD neonates had a more disadvantaged Area Deprivation Index and had surgery at hospitals located in more advantaged regions. Conclusions Although pandemic‐driven care delivery adjustments affected perinatal cardiology referrals and triage, prenatal diagnosis, perioperative outcomes, and survival remained robust. The management of CCHD demonstrates health care resilience, maintaining core prenatal and perioperative care. Regional variations highlight the need for targeted strategies to address disparities during health care crises.https://www.ahajournals.org/doi/10.1161/JAHA.124.037079COVID‐19 impactfetal cardiologyneonatal critical congenital heart disease outcomes |
| spellingShingle | Bhawna Arya Miza Salim Hammoud Andrew J. Toth Joyce Woo Matthew Campbell Angira Patel Lindsay A. Edwards Lindsay Freud Rupali Gandhi Anita Krishnan Shabnam Peyvandi Nelangi Pinto Christina Ronai Kristen Sexson Tejtel Anita Moon‐Grady Mary T. Donofrio Shubhika Srivastava Tara Karamlou Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease COVID‐19 impact fetal cardiology neonatal critical congenital heart disease outcomes |
| title | Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study |
| title_full | Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study |
| title_fullStr | Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study |
| title_full_unstemmed | Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study |
| title_short | Impact of COVID‐19 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study |
| title_sort | impact of covid 19 on prenatal diagnosis and surgical outcomes of congenital heart disease fetal heart society and society of thoracic surgeons collaborative study |
| topic | COVID‐19 impact fetal cardiology neonatal critical congenital heart disease outcomes |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037079 |
| work_keys_str_mv | AT bhawnaarya impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT mizasalimhammoud impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT andrewjtoth impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT joycewoo impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT matthewcampbell impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT angirapatel impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT lindsayaedwards impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT lindsayfreud impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT rupaligandhi impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT anitakrishnan impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT shabnampeyvandi impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT nelangipinto impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT christinaronai impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT kristensexsontejtel impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT anitamoongrady impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT marytdonofrio impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT shubhikasrivastava impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy AT tarakaramlou impactofcovid19onprenataldiagnosisandsurgicaloutcomesofcongenitalheartdiseasefetalheartsocietyandsocietyofthoracicsurgeonscollaborativestudy |