Congenital Heart Disease: Risk Factors, Prenatal Diagnosis, and Outcomes

Dear Colleagues,

Congenital heart disease (CHD) is the most common prenatal defect and occurs in 1:100 babies born every year, and of these, 1:4 undergo cardiac surgery every year. As with every discipline, the time of diagnosis has moved into the prenatal period, and currently more patients with serious congenital heart disease are diagnosed prenatally than postnatally. With improvements in technology, prenatal diagnosis of congenital heart disease of structural heart disease may occur as early as weeks 13 to 15 of gestation. With the earlier identification of congenital heart disease, prenatal treatment options are being explored. Fetal arrhythmias are diagnosed and treated prenatally and prenatal interventional cardiac procedures and their potential role in the natural history of some forms of congenital heart disease are being examined. Moving the timing of diagnosis into the prenatal era has significant associated challenges and responsibilities. Current research must focus on all aspects of prenatal diagnosis, beginning with an examination of screening strategies and whether social determinants of health impact the availability of services. Advances in prenatal genetic screening are essential in counseling families prenatally, and these modalities are becoming increasingly available and essential for parental decision making. Investigators continue to determine strategies for appropriate support of families in this complex and stressful process which begins prenatally, but will extend throughout the lifetime of their patients. Investigators are actively examining strategies for translating our increasing understanding of the prenatal course of congenital heart disease into delivery planning and postnatal management strategies that will support improvements in outcomes. Successes in the current era are defined not only by survival statistics, but also by improvements in the neurocognitive outcome and quality of life. The focus of this Special Issue will include the present status of prenatal diagnosis and screening strategies, current research on parental support, available prenatal therapies, strategies for delivery planning and the impact of prenatal diagnosis on postnatal outcomes. 

Dr. Ann Kavanaugh-Mchugh
Guest Editor
Dr. Bridget B. Zoeller
Co-Guest Editor

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