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Aim This retrospective study was performed to determine the frequency of malformed infants born at a tertiary center in Hokkaido, Japan. The accuracy of prenatal diagnosis rates was also investigated. Methods An observational study was performed using data of 1509 and 1743 newborn infants at a single center during two study periods, 2005-2009 (first) and 2010-2014 (second), respectively. Cases including minor anomalies (accessory auricle, nevus and fistula auris congenita) were not included. Results In total, 274 and 569 malformations were identified in 191 and 337 newborn infants in the first and second study periods, respectively. The number of malformed infants increased significantly over time (13% [191/1509] vs 19% [337/1743], respectively; P < 0.001), mainly as a result of an increase in cases of congenital heart disease (CHD), from 59 to 141 (31% [59/191] vs 42% [141/337] of all malformed infants in the first and second periods, respectively). The overall accurate prenatal diagnosis rate improved over time from 47% (128/274) to 58% (329/569) because of significant improvements in accurate prenatal diagnosis of CHD subtypes (23% [16/70] vs 65% [151/232] in the first and second periods, respectively, P < 0.0001). Conclusions The frequency of malformed newborns was higher in the tertiary center than in the general population. The increased number of cases with prenatal suspicion and diagnosis of CHD contributed to the increased frequency of malformed infants during the study period. [ABSTRACT FROM AUTHOR]

Background: The aim of this retrospective study was to evaluate the influence of prenatal diagnosis on perinatal outcomes of congenital heart disease (CHD) over a 17 year period at a single center. Methods: The perinatal outcome of CHD in 146 patients diagnosed on fetal echocardiography between 1994 and 2010 were reviewed. The characteristics of 193 neonatal inpatients with CHD treated at the authors' department between 2001 and 2010 were also analyzed; among the inpatients, 61 were diagnosed before birth (prenatal group) and 132 were diagnosed after birth (postnatal group). Results: Among the 146 patients prenatally diagnosed with CHD, the prenatal mortality, including abortion and stillbirth, decreased from 1994 to 2010. Among the 193 neonatal inpatients, the prenatal group had lower gestational age and bodyweight than the postnatal group. Further, the prenatal group had lower blood pH at admission, but no patient in that group experienced ductal shock, although six patients in the postnatal group did. The average dose of prostaglandin E1 used in duct-dependent CHD was significantly lower in the prenatal group than in the postnatal group (3.4 vs. 4.6 ng/kg per min; P = 0.015). Conclusions: Prenatal diagnosis of CHD enables planned labor, prevents ductal shock, and reduces prostaglandin E1 side-effects and medical expenditure. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to accurately evaluate the prevalence and outcome of congenital heart disease (CHD) with small for gestational age (SGA)in consecutive newborns. Method: A prospective cohort study was conducted of a series of all livebirth newborns. Two-dimensional and color Doppler echocardiography were performed at 0-4 days of life in 6041 consecutive neonates who were born at Hamamatsu University Hospital, Japan, between May 2005 and April 2015. All newborns with CHD were followed up by echocardiography until a spontaneous resolution of all cardiac lesions occurred or they underwent surgery, received catheter intervention or died. Results: A total of 291 newborns were diagnosed with CHD, while 401 newborns were SGA. Among the newborns with CHD, 46 were SGA (SGA group) and 245 were not (non-SGA group). The prevalence of CHD in the SGA group was significantly higher than that in the non-SGA group (114.7 vs 43.4 per 1000 live birth, p<0.001). Ventricular septal defect was the most frequent cardiac abnormality in both groups. However, the incidence of severe defects in the SGA group was significantly higher than that in the non-SGA group (19.6% vs 7.8%, p=0.025). In addition, the rate of chromosomal or genetic abnormalities in SGA newborns (23.9%) was significantly higher than that observed in newborns without SGA (4.9%, p < 0.0001).Fourteen newborns (30.4%) in the SGA group and 24 newborns (9.8%) in the non-SGA group underwent surgical repair or catheter intervention for cardiac lesions during 6.7±3.3 years of follow-up. Spontaneous resolution of cardiac lesions was observed in 20 (43.5%) newborns in the SGA group and in 145 (59.2%) newborns in the non-SGA group. In the SGA group, the 5-year survival rate and 5-year invasive intervention-free rate were 90.9% and 63.6%, respectively. These rates were significantly lower in comparison to the non-SGA group (99.6% and 87.8%, respectively; log-rank test, p<0.0001). A logistic regression analysis that included clinical characteristics and echocardiographic parameters showed that SGA newborns exhibited a significantly increased risk ofinvasive interventionand death (adjusted OR, 8.22; 95% CI, 2.37-28.52; p=0.001). Conclusion: This study was conducted to prospectively elucidate the association between SGA and CHD in a large cohort of consecutive newborns by echocardiography. The prevalence of CHD in the present study was markedly higher in the SGA newborns. Furthermore, these neonates had a higher risk of mid-term mortality and invasive intervention in comparison to non-SGA newborns. [ABSTRACT FROM AUTHOR]