Prenatal diagnosis of congenital heart disease: trends in pregnancy termination rate, and perinatal and 1-year infant mortalities in Korea between 1994 and 2005.
OBJECTIVE
To determine the pregnancy termination rate, and perinatal and 1-year infant mortality rates following prenatally-detected congenital heart disease (CHD) and trends over an 11-year period.


METHODS
Between 1994 and 2005, 1603 gravidas underwent fetal echocardiography in our institution, in which 378 fetuses were diagnosed with CHD. The study period was divided into the following three groups for time-trend analysis: 1994-1997, 1998-2001, and 2002-2005. Data regarding gestational age at diagnosis and delivery, the presence of extracardiac or chromosomal abnormalities, pregnancy termination rate, and perinatal and 1-year mortalities were collected by review of medical records and telephone interviews.


RESULTS
Among 378 fetuses with a prenatally-detected CHD, complete perinatal and infant outcomes were available for 336 fetuses (88.9%). There was a gradual increase in prenatally-detected CHD by fetal echocardiography during the study period (1994-1997, 10.3%; 1998-2001, 17.3%; and 2002-2005, 24.3%). The mean gestational ages at diagnosis and delivery were 27.2 +/- 5.6 and 37.8 +/- 2.9 weeks, respectively. Overall, the pregnancy termination rate in this study population was 20.2% and the perinatal and 1-year infant mortality rates were 6.3% and 9.7%, respectively. Among the fetuses who underwent cardiac surgery, surgical mortality occurred in two (3.8%); both died more than 1 month after surgery. Although the pregnancy termination rates remained unchanged, there was a significant decrease in perinatal and 1-year infant mortality rates over the study period.


CONCLUSIONS
Although the perinatal and 1-year infant mortalities following prenatally-detected CHD have continued to decrease significantly during the past 11 years, pregnancy termination rates have remained unchanged.
Lee
Ji Eun
JE
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jung
Kyung-Lan
KL
Kim
Sei-Eun
SE
Nam
Soo-Hyun
SH
Choi
Suk-Joo
SJ
Oh
Soo-Young
SY
Roh
Cheong-Rae
CR
Kim
Jong-Hwa
JH
D000028:Abortion, Induced / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007723:Korea / Q000453:epidemiology; D011247:Pregnancy; D016216:Ultrasonography, Prenatal