The implementation of a nationwide anomaly screening programme improves prenatal detection of major cardiac defects : an 11-year national population-based cohort study

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Hautala , J , Gissler , M , Ritvanen , A , Tekay , A , Pitkänen-Argillander , O , Stefanovic , V , Sarkola , T , Helle , E , Pihkala , J , Pätilä , T , Mattila , I P , Jokinen , E , Räsänen , J & Ojala , T 2019 , ' The implementation of a nationwide anomaly screening programme improves prenatal detection of major cardiac defects : an 11-year national population-based cohort study ' , BJOG : An International Journal of Obstetrics & Gynaecology , vol. 126 , no. 7 , pp. 864-873 . https://doi.org/10.1111/1471-0528.15589

Title: The implementation of a nationwide anomaly screening programme improves prenatal detection of major cardiac defects : an 11-year national population-based cohort study
Author: Hautala, J.; Gissler, M.; Ritvanen, A.; Tekay, A.; Pitkänen-Argillander, O.; Stefanovic, V.; Sarkola, T.; Helle, E.; Pihkala, J.; Pätilä, T.; Mattila, I. P.; Jokinen, E.; Räsänen, J.; Ojala, T.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, University of Helsinki
University of Helsinki, Research Programs Unit
University of Helsinki, Children's Hospital
University of Helsinki, III kirurgian klinikka
University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, Lastentautien yksikkö
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Children's Hospital
Date: 2019-06
Language: eng
Number of pages: 10
Belongs to series: BJOG : An International Journal of Obstetrics & Gynaecology
ISSN: 1470-0328
URI: http://hdl.handle.net/10138/308712
Abstract: Objective To evaluate whether a nationwide prenatal anomaly screening programme improves detection rates of univentricular heart (UVH) and transposition of great arteries (TGA), and whether maternal risk factors for severe fetal heart disease affect prenatal detection. Design Population-based cohort study. Setting Nationwide data from Finnish registries 2004-14. Population A total of 642 456 parturients and 3449 terminated pregnancies due to severe fetal anomaly. Methods Prenatal detection rates were calculated in three time periods (prescreening, transition and screening phase). The effect of maternal risk factors (obesity, in vitro fertilisation, pregestational diabetes and smoking) was evaluated. Main outcome measures Change in detection rates and impact of maternal risk factors on screening programme efficacy. Results In total, 483 cases of UVH and 184 of TGA were detected. The prenatal detection rate of UVH increased from 50.4% to 82.8% and of TGA from 12.3% to 41.0% (P <0.0001). Maternal risk factors did not affect prenatal detection rate, but detection rate differed substantially by region. Conclusions A nationwide screening programme improved overall UVH and TGA detection rates, but regional differences were observed. Obesity or other maternal risk factors did not affect the screening programme efficacy. The establishment of structured guidelines and recommendations is essential when implementing the screening programme. In addition, a prospective screening register is highly recommended to ensure high quality of screening.
Subject: Congenital heart disease
prenatal diagnosis
prenatal screening
transposition of great arteries
univentricular heart
CONGENITAL HEART-DISEASE
BIRTH PREVALENCE
MATERNAL OBESITY
PRACTICE GUIDELINES
GREAT-ARTERIES
DIAGNOSIS
RISK
MORTALITY
TRANSPOSITION
TRENDS
3123 Gynaecology and paediatrics
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