Assessment of risk factors for congenital heart disease through prenatal fetal echocardiography and the correlation with postnatal diagnoses

Background: Congenital Heart Disease (CHD) constitutes a significant cause of morbidity and mortality in newborns. Identifying CHD prenatally and understanding associated risk factors can aid in early diagnosis, intervention, and postnatal management. This study aims to assess risk factors for CHD using prenatal fetal echocardiography (FE) and investigate their correlation with postnatal diagnoses.
Patients and Methods: In this study, we included 993 pregnant women presenting to the pediatric cardiology outpatient clinic between December 2018 and December 2020, considered at risk for CHD. We retrospectively evaluated the cases’ postnatal echocardiography data with detected CHD during fetal echocardiography.
Results: The average age of the patients was 29.8±5.7, and the mean gestational week was 23.61±3.9. Among the pregnant women, 253 (25.47%) were primiparous, 740 (74.53%) were multiparous, 103 cases (9.32%) involved multiple pregnancies, and 259 (26.08%) had chronic diseases. The most common reason for fetal echocardiography referral was the suspicion of CHD in fetuses with dysmorphic findings detected during obstetric ultrasonography. Among the cases, 329 (33.1%) were classified as low-risk, while 664 (66.9%) as high-risk. Among all patients, the most commonly observed prenatal CHD were Ventricular Septal Defects (VSD) (8.2%), Hydrops Fetalis (6.1%), and large Atrial Septal Defects (ASD) (3.9%). The overall prevalence of CHD was 31.6%. The accuracy of postnatal echocardiography in confirming the diagnoses made with fetal echocardiography was 94%.
Conclusion: Prenatal diagnosis of congenital heart diseases is crucial for planning prenatal and postnatal management and providing families with the option of pregnancy termination in severe anomalies. Fetal echocardiography has shown significant potential for early diagnosis of CHD, even in low-risk fetuses, and its inclusion in routine prenatal screenings by increasing the number of experienced specialists and centers could play a crucial role in reducing CHD-related mortality and morbidity rates.