Prenatal care coordination, racial and socioeconomic inequities, and pre- and post-operative outcomes in hypoplastic left heart syndrome

David N. Schidlow, Kimberlee Gauvreau, Emily M. Bucholz, Amy Bennett, Terra Lafranchi, Jay Pruetz, Christina Ronai, Jeffrey Vergales, David W. Brown

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We sought to identify associations between prenatal care coordination (PNC) and outcomes in hypoplastic left heart syndrome (HLHS). Study design: We hypothesized that suboptimal PNC is associated with worse pre-operative status. HLHS patients from 2016 through 2019 were identified using a multicenter registry. Optimal PNC was defined as (1) a completed interdisciplinary conference and (2) closed-loop communication with the obstetric team. Associations between PNC and outcomes were identified. Results: Of 1441 patients, 1242 (86%) had prenatal diagnosis. Among those with a prenatal diagnosis, PNC was achieved in only 845 (68%). Suboptimal PNC was associated with adverse events (50% vs 40%, p < 0.001), inotrope need (19% vs 13%, p = 0.007), mechanical ventilation (22% vs 16%, p = 0.016), and parenteral feeding (60% vs 46%, p < 0.001). African–American race and non-commercial insurance were associated with a lower likelihood of optimal PNC (p = 0.006 and p < 0.001, respectively). Conclusion: Improving PNC and overcoming racial and socioeconomic barriers are important targets to improve HLHS perinatal care.

Original languageEnglish (US)
Pages (from-to)378-384
Number of pages7
JournalJournal of Perinatology
Volume43
Issue number3
DOIs
StatePublished - Mar 2023
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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