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Impact of standardized prenatal documentation among newborns with ductal-dependent heart disease

Journal of Perinatology volume 40, pages 1531–1536 (2020)Cite this article

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Abstract

Introduction

Absent risk stratification, variable physiology of ductal-dependent congenital heart disease (DD-CHD) imparts risk of over-medicalization and unnecessary exclusion from early parental bonding.

Methods

Single-center retrospective cohort study of term infants with isolated prenatally diagnosed DD-CHD expected to require immediate advanced resuscitation/intervention (2005–2017). Standardized documentation (2015 onward) included diagnosis, expected saturations, and allowability of postnatal parental bonding.

Results

The study cohort (n = 386) included 289 patients in the pre-standardized documentation era and 97 in the post-era; the groups had similar characteristics. Fewer infants were born by cesarean in the later era (32% vs. 22%; p = 0.049). Decrease in any respiratory intervention (38–26%; p = 0.03) followed standardized documentation. More patients had any bonding time (22–74%; p < 0.0001), without increase in CPAP or intubation in the first two hours of life (6.9% vs. 7.2%; p = 0.92).

Conclusion

Standardized predelivery documentation for neonates with DD-CHD decreased unnecessary respiratory intervention and increased parental bonding.

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Fig. 1: Respiratory intervention by type between eras.
Fig. 2: Documented Parental Bonding by Era.

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Authors and Affiliations

  1. Department of Pediatrics, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA

    Ian Thomas, Naomi T. Laventhal, Sunkyung Yu, Ray Lowery & Sarah Gelehrter

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Contributions

IT conceptualized and designed the study, collected data, drafted the initial paper and reviewed and revised the paper. SG conceptualized and designed the study, supervised data collection, and reviewed and revised the paper. NTL conceptualized and designed the study and reviewed and revised the paper. SY carried out the statistical analysis and reviewed and revised the paper. RL designed the data collection instruments, supervised data collection and carried out parts of the analysis. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Naomi T. Laventhal.

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Thomas, I., Laventhal, N.T., Yu, S. et al. Impact of standardized prenatal documentation among newborns with ductal-dependent heart disease. J Perinatol 40, 1531–1536 (2020). https://doi.org/10.1038/s41372-020-0674-5

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