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Multicenter Study Led by Texas Children's Hospital & Baylor College of Medicine Finds Prenatal Diagnosis & Birth Location May Significantly Improve Neonatal HLHS Survival
Date:10/25/2013

diology in the department of pediatrics at BCM and contributing author on the study. “This study sheds light on delivery distance in addition to prenatal and postnatal diagnosis. If an infant is diagnosed after they are born, it is crucial that they are cared for at a center with expertise and high HLHS volumes.”

The research, conducted by experts from BCM, the Texas Department of State Health Services, University of Texas Southwestern Medical Center in Dallas and the University of South Florida, used the Texas Department of State Health Services’ Texas Birth Defects Registry data from 1999-2007 to retrospectively examine the associations between distance from birth center to a cardiac surgical center, number of newborns cared for with HLHS at each hospital, and neonatal mortality in infants with HLHS.

Of the more than 3.4 million births during the study period, 463 infants with HLHS were assessed. Mothers delivering farther from a cardiac surgical center were less educated and more often lived in a poverty-stricken area. Additionally, 39 percent of newborns studied were prenatally diagnosed with HLHS and delivered significantly closer to a cardiac surgical center. Forty percent of newborns with HLHS died that were born more than 90 minutes from a cardiac surgical center, compared to 21 percent of those born within 10 minutes of a surgical center. The percentage of patients that died after the first surgery for HLHS was two to four times higher in low volume surgical centers than in the highest volume centers. Overall, in the latest years of the study, newborns with a prenatal diagnosis, born less than10 minutes from a cardiac surgical center, and cared for at a large volume cardiac surgical center, had a neonatal mortality of 6 percent. For those born in the same era without a prenatal diagnosis, more than10 miles from a cardiac surgical center, and cared for at a low volume cardiac surgical center, 28-day mortality was 29 percent.

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