title: Efficacy of prenatal diagnosis of major congenital heart disease on perinatal management and perioperative mortality: a meta-analysis.
abstract: BACKGROUND
  There is no consensus on the effectiveness of prenatal diagnosis except for hospitalized outcomes. Hence, a meta-analysis of published literature was conducted to assess the effect of prenatal diagnosis.
  
  
  METHODS
  Literature review has identified relevant studies up to December 2013. A meta-analysis was performed according to the guidelines from the Cochrane review group and the PRISMA statement. Studies were identified by searching PubMed, Embase, the Cochrane Central Register of Controlled Trials and World Health Orgnization clinical trials registry center. Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1 according to the guidelines from the Cochrane review group and the PRISMA guidelines.
  
  
  RESULTS
  The results from 13 cohort studies in 12 articles were analyzed to determine the optimal treatment with the lower rate of perioperative mortality in prenatal diagnosis. The superiority of a prenatal diagnosis has been proven because the surgical procedure could be done in the early neonatal period (95% CI, -0.76, -0.40). The prenatal diagnosis has also remarkably reduced the preoperative and postoperative mortality rates in cases of transposition of the great arteries (95% CI=0.06, 0.80; 95% CI=0.01, 0.82, respectively), as well as the overall results with all subtypes (95% CI=0.18, 0.94; 95% CI=0.46, 0.94, respectively).
  
  
  CONCLUSIONS
  Prenatal diagnosis is effective in perinatal management with an earlier intervention for major congenital heart disease, but only results in a reduced perioperative mortality in cases of transposition of the great arteries. Further investigations are required to evaluate the effect of prenatal diagnosis on life quality during a long-term follow-up.
authors.affiliation: Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, Chengdu, China.|West China Medical School, Chengdu, China.
authors.forename: Yi-Fei
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, Chengdu, China.|Program for Yangtze River Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Kai-Yu
authors.initials: KY
authors.lastname: Zhou
authors.affiliation: West China Stomatology School, Sichuan University, Chengdu, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Fang
authors.affiliation: Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, Chengdu, China.|West China Medical School, Chengdu, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, Chengdu, China.|Program for Yangtze River Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Hua
authors.affiliation: Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, Chengdu, China. dezhi.mu@ucsf.edu.|Program for Yangtze River Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, China. dezhi.mu@ucsf.edu.
authors.forename: De-Zhi
authors.initials: DZ
authors.lastname: Mu
mesh_terms: D001724:Birth Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020380:Needs Assessment; D054238:Perinatal Mortality / Q000639:trends*; D019990:Perioperative Care / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis
keywords: congenital heart disease; delivery; echocardiography; fetal diagnosis; meta-analysis