Arteries Effect of Prenatal Diagnosis on Outcomes in D-Transposition of the Great

ABSTRACT. Background. By decreasing preoperativemorbidity, prenatal diagnosis could improve neurode-velopmental outcomes in infants with critical congenitalheart disease. We explored the impact of prenatal diag-nosis on perinatal and perioperative variables and onoutcomes at 1 year of age. Methods. We analyzed a database of children en-rolled in prospective studies on surgical support tech-niques from 1988 to 2000. Selection criteria included adiagnosis of D-transposition of the great arteries withintact ventricular septum or ventricular septal defect, noextracardiac congenital anomalies, birth weight >2.3 kg,and repair by arterial switch procedure. Results. Of 346 patients at enrollment, 25 had a pre-natal diagnosis, and 321 did not. Children with prenataldiagnosis, compared with those without, had a lowerlikelihood of birth by spontaneous labor, lower birthweights, lower Apgar 5 scores, a higher rate of preoper-ative endotracheal intubation, and surgery at a youngerage. They tended to have a lower incidence of fetal dis-tress during labor. At 1 year of age, 272 patients weretested with the Psychomotor Development Index andMental Development Index of the Bayley Scales. Mean