{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:05:22Z","timestamp":1789005922854,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Early prenatal detection of congenital heart disease (CHD) allows mothers to plan for their pregnancy and delivery; however, the effect of certain sociodemographic and fetal factors on prenatal care has not been investigated thoroughly. This study evaluated the impact of maternal and fetal characteristics on the timing of prenatal diagnosis of CHD and fetal and postnatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter cohort study included women with a fetal echocardiographic diagnosis of CHD between 2010 and 2019. Women were grouped into quartiles of social vulnerability (quartiles 1\u20134; low\u2013high) using the 2014 social vulnerability index (SVI) provided by the Centers for Disease Control and Prevention. A fetal disease severity score (range, 1\u20137) was calculated based on a combination of CHD severity (mild\u2009=\u20091; moderate\u2009=\u20092; severe, two ventricles\u2009=\u20093; severe, single ventricle\u2009=\u20094 points) and prenatally diagnosed genetic abnormality, non\u2010cardiac abnormality and fetal hydrops (1 point each). Late diagnosis was defined as a fetal echocardiographic diagnosis of CHD after 24\u2009weeks' gestation. Univariate and multivariable regression analyses were used to identify factors associated with late diagnosis, termination of pregnancy (TOP), postnatal death, prenatal\u2013postnatal discordance in CHD diagnosis and severity and, for liveborn infants, to identify which prenatal variables were associated with postnatal death or heart transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 441 pregnancies included, 94 (21%) had a late diagnosis of CHD. Late diagnosis was more common in the most socially vulnerable quartile, 38% of women in this group having diagnosis &gt;\u200924\u2009weeks, compared with 14\u201318% in the other three quartile groups. Late diagnosis was also associated with Catholic or other Christian religion\n                      <jats:italic>vs<\/jats:italic>\n                      non\u2010denominational or other religion and with a lower fetal disease severity score. There were 93 (21%) TOP and 26 (6%)\n                      <jats:italic>in\u2010utero<\/jats:italic>\n                      fetal demises. Factors associated with TOP included early diagnosis and greater fetal disease severity. Compared with the other quartiles, the most socially vulnerable quartile had a higher incidence of\n                      <jats:italic>in\u2010utero<\/jats:italic>\n                      fetal demise and a lower incidence of TOP. Among the 322 liveborn infants, 49 (15%) died or underwent heart transplant during the follow\u2010up period (range, 0\u201316\u2009months). Factors associated with postnatal death or heart transplant included longer delay between obstetric ultrasound examination at which CHD was first suspected and fetal echocardiogram at which CHD was confirmed and greater fetal disease severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High social vulnerability, Catholic or other Christian religion and low fetal disease severity are associated with late prenatal CHD diagnosis. Delays in CHD diagnosis are associated with fewer TOPs and worse postnatal outcome. Therefore, efforts to expedite fetal echocardiography following abnormal obstetric screening, particularly for at\u2010risk women (e.g. those with high SVI), have the potential to impact pregnancy and postnatal outcome among the prenatally diagnosed CHD population. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.24863","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T11:46:01Z","timestamp":1642765561000},"page":"346-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Impact of maternal social vulnerability and timing of prenatal care on outcome of prenatally detected congenital heart disease"],"prefix":"10.1002","volume":"60","author":[{"given":"M. T.","family":"Perez","sequence":"first","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"},{"name":"Department of Pediatrics Warren Alpert Medical School of Brown University  Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Bucholz","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Asimacopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"},{"name":"Department of General Surgery and Surgical Specialties \u2018Paride Stefanini\u2019 Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Schauer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seattle Children's Hospital  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Holleman","sequence":"additional","affiliation":[{"name":"Amherst College  Amherst MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sekhavat","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"},{"name":"Department of Pediatrics Boston Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Tworetzky","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J.","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Sleeper","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-8932","authenticated-orcid":false,"given":"R. S.","family":"Beroukhim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15742"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14751"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.2009"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003711"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.053062"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.108.802868"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4622"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3949"},{"key":"e_1_2_7_10_1","unstructured":"ATSDR.Agency for Toxic Substances and Disease Registry. CDC\/ATSDR Social Vulnerability Index.https:\/\/www.atsdr.cdc.gov\/placeandhealth\/svi\/index.html."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2202\/1547-7355.1792"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-019-02792-7"},{"key":"e_1_2_7_13_1","unstructured":"Registry of Vital Records and Statistics (RVRS).https:\/\/www.mass.gov\/orgs\/registry\u2010of\u2010vital\u2010records\u2010and\u2010statistics."},{"key":"e_1_2_7_14_1","unstructured":"Massachusetts Center for Birth Defects Research and Prevention.Massachusetts Birth Defects Monitoring Program. Massachusetts Birth Defects Surveillance Reports.https:\/\/www.mass.gov\/lists\/massachusetts\u2010birth\u2010defects\u2010surveillance\u2010reports."},{"key":"e_1_2_7_15_1","unstructured":"United States Census Bureau.https:\/\/www.census.gov."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1655"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.9.1269"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.12.036"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4282"},{"key":"e_1_2_7_20_1","unstructured":"ATSDR.Agency for Toxic Substances and Disease Registry. CDC's Social Vulnerability Index (SVI). SVI Interactive Map.https:\/\/svi.cdc.gov\/map.html."},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306985"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4306"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2013.02.001"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12403"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.09030173.x"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24863","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.24863","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T01:33:23Z","timestamp":1692754403000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.24863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/uog.24863"],"URL":"https:\/\/doi.org\/10.1002\/uog.24863","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9]]},"assertion":[{"value":"2021-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}