This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kuehl, K. S.
Right arrow Articles by Ferencz, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kuehl, K. S.
Right arrow Articles by Ferencz, C.
Related Collections
Right arrow Heart & Blood Vessels

PEDIATRICS Vol. 103 No. 4 April 1999, pp. 743-747

Failure to Diagnose Congenital Heart Disease in Infancy

Received Apr 17, 1997; accepted Sep 29, 1998.

Karen S. Kuehl*, Christopher A. LoffredoDagger , and Charlotte FerenczDagger

From the * Children's National Medical Center, Washington, DC; and the Dagger  Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Objective.  To identify factors that predict failure to diagnose congenital heart disease in newborns.

Design.  All fatal cases in the Baltimore-Washington Infant Study were compiled. The Baltimore-Washington Infant Study includes 4390 cases of infants with congenital cardiovascular malformations identified in a population-based study between 1981 and 1989 in the Baltimore-Washington metropolitan area. Death occurred in 800 such infants in the first year of life. In 76 of these infants, death occurred before diagnosis of heart disease. These cases were identified by community search of autopsy records. Their characteristics are compared with those of infants who died after a cardiac diagnosis was made.

Results.  Infant characteristics (birth weight, gestational age, intrauterine growth retardation, and chromosomal anomaly) are associated with death of infants with congenital cardiovascular malformations and with death of such infants before diagnosis. Diagnoses of coarctation of the aorta, Ebstein's anomaly, atrial septal defect, and truncus arteriosus are overrepresented in infants found by community search, particularly in those infants without associated malformations. Paternal education is associated with failure to diagnose congenital heart disease in life but other sociodemographic characteristics of the infant's family are not.

Conclusions.  Diagnosis of congenital cardiovascular malformations requires close observation in the neonatal period. Analysis of age at death of infants with undiagnosed congenital cardiovascular malformation suggests that such infants may be at risk if discharged within the first 2 days of life.  Key words:  infant mortality, congenital heart disease, health policy, newborn hospitalization.




This article has been cited by other articles:


Home page
 J Ultrasound MedHome page
R. J. Acherman, W. N. Evans, C. F. Luna, R. Rollins, K. T. Kip, J. C. Collazos, H. Restrepo, J. Adasheck, B. K. Iriye, D. Roberts, et al.
Prenatal Detection of Congenital Heart Disease in Southern Nevada: The Need for Universal Fetal Cardiac Evaluation
J. Ultrasound Med., December 1, 2007; 26(12): 1715 - 1719.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
P. Valmari
Should pulse oximetry be used to screen for congenital heart disease?
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F219 - F224.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
S. Thangaratinam, J. Daniels, A. K Ewer, J. Zamora, and K. S Khan
Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: a systematic review
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F176 - F180.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. R. Liske, C. S. Greeley, D. J. Law, J. D. Reich, W. R. Morrow, H. S. Baldwin, T. P. Graham, A. W. Strauss, A. L. Kavanaugh-McHugh, and W. F. Walsh
Report of the Tennessee Task Force on Screening Newborn Infants for Critical Congenital Heart Disease
Pediatrics, October 1, 2006; 118(4): e1250 - e1256.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
K L Brown, D A Ridout, A Hoskote, L Verhulst, M Ricci, and C Bull
Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates
Heart, September 1, 2006; 92(9): 1298 - 1302.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
S. Quaglini, C. Rognoni, C. Spazzolini, S. G. Priori, S. Mannarino, and P. J. Schwartz
Cost-effectiveness of neonatal ECG screening for the long QT syndrome
Eur. Heart J., August 1, 2006; 27(15): 1824 - 1832.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. Datar and N. Sood
Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California
Pediatrics, July 1, 2006; 118(1): 63 - 72.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
M M Massin and H Dessy
Delayed recognition of congenital heart disease.
Postgrad. Med. J., July 1, 2006; 82(969): 468 - 470.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. D. Malkin, E. Keeler, M. S. Broder, and S. Garber
Postpartum Length of Stay and Newborn Health: A Cost-Effectiveness Analysis
Pediatrics, April 1, 2003; 111(4): e316 - 322.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
R. I. Koppel, C. M. Druschel, T. Carter, B. E. Goldberg, P. N. Mehta, R. Talwar, and F. Z. Bierman
Effectiveness of Pulse Oximetry Screening for Congenital Heart Disease in Asymptomatic Newborns
Pediatrics, March 1, 2003; 111(3): 451 - 455.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
J. I. E. Hoffman and S. Kaplan
The incidence of congenital heart disease
J. Am. Coll. Cardiol., June 19, 2002; 39(12): 1890 - 1900.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. T. Mahle, R. R. Clancy, S. P. McGaurn, J. E. Goin, and B. J. Clark
Impact of Prenatal Diagnosis on Survival and Early Neurologic Morbidity in Neonates With the Hypoplastic Left Heart Syndrome
Pediatrics, June 1, 2001; 107(6): 1277 - 1282.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
D J PENNY and L S SHEKERDEMIAN
Management of the neonate with symptomatic congenital heart disease
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2001; 84(3): 141F - 145.
[Full Text]

Home page
 Obstet GynecolHome page
J. D. MALKIN, S. GARBER, M. S. BRODER, and E. KEELER
Infant Mortality and Early Postpartum Discharge
Obstet. Gynecol., August 1, 2000; 96(2): 183 - 188.
[Abstract] [Full Text] [PDF]