{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:22:06Z","timestamp":1773829326794,"version":"3.50.1"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951122003250_as1\"><jats:title>Objective<\/jats:title><jats:p>To study the impact of out-of-hours delivery on outcome for neonates with antenatally diagnosed transposition of the great arteries.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003250_as2\"><jats:title>Setting<\/jats:title><jats:p>Tertiary paediatric cardiology centre (Yorkshire, United Kingdom), with co-located tertiary neonatal unit.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003250_as3\"><jats:title>Patients<\/jats:title><jats:p>Neonates with antenatally diagnosed simple transposition of the great arteries delivered out-of-hours (Monday to Friday 17:00\u201308:00 and weekends) <jats:italic>versus<\/jats:italic> in-hours between 2015 and 2020.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003250_as4\"><jats:title>Outcome<\/jats:title><jats:p>The primary outcome was survival to hospital discharge. Secondary outcomes included neurological morbidity, length of stay, and time to balloon atrial septostomy.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003250_as5\"><jats:title>Results<\/jats:title><jats:p>Of 51 neonates, 38 (75%) were delivered out-of-hours. All neonates born in the tertiary centre survived to discharge. Time to balloon atrial septostomy was slightly longer for out-of-hours deliveries compared to in-hours (median 130 versus 93 mins, p = 0.33). Neurological morbidity occurred for nine (24%) patients in the out-of-hours group and one (8%) in-hours (OR 3.72, 95% CI: 0.42\u201332.71, p = 0.24). Length of stay was also similar (18.5 versus 17.3 days, p = 0.59). Antenatal diagnosis of a restrictive atrial septum was associated with a lower initial pH (7.03 versus 7.13; CI: 0.03\u20130.17, p = 0.01), longer length of stay (22.6 versus 17.3 days; CI: 0.37\u201310.17, p = 0.04), and increased neurological morbidity (44% versus 14%; OR 4.80, CI 1.00\u201323.15, p = 0.05). A further three neonates were delivered in surrounding hospitals, with a mortality of 67% (versus 0 in tertiary centre; OR 172, CI 5-5371, p = 0.003).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003250_as6\"><jats:title>Conclusion<\/jats:title><jats:p>Neonates with antenatally diagnosed transposition of the great arteries have similar outcomes when delivered out-of-hours <jats:italic>versus<\/jats:italic> in-hours. Antenatal diagnosis of restrictive atrial septum is a significant predictor of worse outcomes. In our region, delivery outside the tertiary cardiac centre had a significantly higher risk of mortality.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951122003250","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T09:28:36Z","timestamp":1667467716000},"page":"1873-1878","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Out-of-hours versus in-hours delivery of antenatally diagnosed transposition of the great arteries: outcomes from a United Kingdom Tertiary Centre"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0041-0862","authenticated-orcid":false,"given":"Daniel G.W.","family":"Cave","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Lillitos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Lancaster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Bentham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuba","family":"Barwick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,11,3]]},"reference":[{"key":"S1047951122003250_ref2","unstructured":"2. Public Health England. NHS Fetal Anomaly Screening Handbook (FASP) 2021, https:\/\/www.gov.uk\/government\/publications\/fetal-anomaly-screening-programme-handbook\/20-week-screening-scan."},{"key":"S1047951122003250_ref4","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.7.916"},{"key":"S1047951122003250_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14027"},{"key":"S1047951122003250_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951112000364"},{"key":"S1047951122003250_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5848-x"},{"key":"S1047951122003250_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951110000296"},{"key":"S1047951122003250_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14689"},{"key":"S1047951122003250_ref1","unstructured":"1. NICOR. National Congenital Heart Disease Audit (NCHDA) 2021 summary report (2017\/20 data) 2021, https:\/\/www.nicor.org.uk\/wp-content\/uploads\/2021\/10\/NCHDA-Domain-Report_2021_FINAL.pdf."},{"key":"S1047951122003250_ref6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa020846"},{"key":"S1047951122003250_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100379"},{"key":"S1047951122003250_ref17","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144141.18560.CF"},{"key":"S1047951122003250_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.01.010"},{"key":"S1047951122003250_ref5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.760819"},{"key":"S1047951122003250_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/00019501-199302000-00005"},{"key":"S1047951122003250_ref8","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"S1047951122003250_ref14","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14751"},{"key":"S1047951122003250_ref15","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.9.1209"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951122003250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T10:16:56Z","timestamp":1697019416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951122003250\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,3]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["S1047951122003250"],"URL":"https:\/\/doi.org\/10.1017\/s1047951122003250","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,3]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}