{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:49:17Z","timestamp":1782100157612,"version":"3.54.5"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":171,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prenatal detection rate (PDR) of congenital heart disease (CHD) has been scarcely reported in Japan. This study aimed to investigate PDR of critical CHD in a region of Japan and to evaluate the impact of prenatal diagnosis on postnatal mortality and severe morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We included patients diagnosed with CHD either prenatally and postnatally between January 1st 2018 and December 31st 2020, based on the institutional database. The Kyu\u2010Yama region comprises the seven prefectures of Kyushu island, Yamaguchi prefecture, and Okinawa prefecture. Clinical outcome was compared with prenatal versus postnatal diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall PDR of critical CHD in the region was 64% (400 of 626 cases). Fifty\u2010four (14%) fetuses were diagnosed within 22\u2009weeks of gestational age. Among these cases, termination of pregnancy was selected in 5 (1%) cases. In subgroup analyses by CHD type, heterotaxy had the highest detection rate (91%), followed by hypoplastic left heart syndrome (86%). In contrast, lower detection rates were observed in transposition of the great arteries (43%) and total anomalous pulmonary venous connection (15%). Detection rates varied by prefectures, ranging from 41% to 75%. Among actively managed cases, overall, there was a significant difference in mortality and severe morbidity between prenatal and postnatal groups [66 (18%) vs. 20 (9%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0031].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The overall PDR in this regional cohort was favorable; however, substantial differences remained across prefectures and CHD types. Reducing these disparities may require guideline\u2010based education. Further research is warranted to clarify the prognostic impact of prenatal diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70467","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:12:47Z","timestamp":1782097967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Population\u2010Based Study of Prenatal Detection of Critical Congenital Heart Disease in Kyu\u2010Yama Region of Japan"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8034-6228","authenticated-orcid":false,"given":"Hazumu","family":"Nagata","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7350-6311","authenticated-orcid":false,"given":"Yuzo","family":"Kitadai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Fukuoka Children's Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Oita Prefecture Hospital  Oita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhisa","family":"Shinya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kagoshima University Hospital  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Sugitani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Japan Community Healthcare Organization Kyushu Hospital  Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1882-0785","authenticated-orcid":false,"given":"Masako","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9641-8860","authenticated-orcid":false,"given":"Koutaro","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Miyazaki Hospital  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Yamaguchi University Graduate School of Medicine  Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuya","family":"Shimabukuro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Okinawa Prefectural Nanbu Medical Center &amp; Children's Medical Center  Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saga University Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Kozuma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology NHO Saga Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Japan Community Healthcare Organization Kyushu Hospital  Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9968-2248","authenticated-orcid":false,"given":"Junpei","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Hospital  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuhiro","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Kumamoto City Hospital  Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yozo","family":"Teramachi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics &amp; Child Health Kurume University School of Medicine  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Fetal Cardiology Fukuoka Children's Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuki","family":"Maeno","sequence":"additional","affiliation":[{"name":"Division of Neonatology St. Mary's Hospital  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nishibatake","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima Seikyo Hospital  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"483","DOI":"10.2169\/internalmedicine.4264-24","article-title":"Transitional Care for Adult Patients With Congenital Heart Disease","volume":"64","author":"Harada M.","year":"2025","journal-title":"Internal Medicine"},{"issue":"14","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13144244","article-title":"Comparison of Morbidity and Mortality Outcomes Between Hybrid Palliation and Norwood Palliation Procedures for Hypoplastic Left Heart Syndrome: Meta\u2010Analysis and Systematic Review","volume":"13","author":"Iskander C.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"3","key":"e_1_2_9_4_1","article-title":"Advancements in Prenatal Diagnosis and Management of Hypoplastic Left Heart Syndrome: A Multidisciplinary Approach and Future Directions","volume":"17","author":"Bokhari S. F. H.","year":"2025","journal-title":"World Journal of Cardiology"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/1471-0528.13274","article-title":"Prenatal Detection of Congenital Heart Disease\u2014Results of a National Screening Programme","volume":"123","author":"Van Velzen C. L.","year":"2016","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"issue":"9","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.34069","article-title":"Pregnancy Termination and Postnatal Major Congenital Heart Defect Prevalence After Introduction of Prenatal Cardiac Screening","volume":"6","author":"Tomek V.","year":"2023","journal-title":"JAMA Network Open"},{"issue":"11","key":"e_1_2_9_7_1","article-title":"Impact and Problems of Fetal Echocardiography: A Single\u2010Institution Study in Japan","volume":"14","author":"Yonehara K.","year":"2022","journal-title":"Cureus"},{"issue":"10","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.cjca.2020.01.010","article-title":"Prenatal Diagnosis of Transposition of the Great Arteries Reduces Postnatal Mortality: A Population\u2010Based Study","volume":"36","author":"Nagata H.","year":"2020","journal-title":"Canadian Journal of Cardiology"},{"issue":"6","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.jjcc.2021.08.013","article-title":"Initial National Investigation of the Prenatal Diagnosis of Congenital Heart Malformations in Japan\u2010Regional Detection Rate and Emergency Transfer From 2013 to 2017","volume":"78","author":"Matsui H.","year":"2021","journal-title":"Journal of Cardiology"},{"issue":"12","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1253\/circj.CJ-20-0316","article-title":"Discrepancy Between Pre\u2010 and Postnatal Diagnoses of Congenital Heart Disease and Impact on Neonatal Clinical Course\u2014A Retrospective Study at a Japanese Tertiary Institution","volume":"84","author":"Kurosaki K.","year":"2020","journal-title":"Circulation Journal"},{"issue":"1","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","DOI":"10.1111\/ped.15098","article-title":"Transition in Cardiology 2: Maternal and Fetal Congenital Heart Disease","volume":"64","author":"Nagata H.","year":"2022","journal-title":"Pediatrics International"},{"issue":"5","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"e285","DOI":"10.1542\/neo.24-5-e285","article-title":"Prenatal Diagnosis, Management, and Treatment of Fetal Cardiac Disease","volume":"24","author":"Sethi N.","year":"2023","journal-title":"NeoReviews"},{"issue":"5","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1002\/jum.14453","article-title":"Advancing Prenatal Detection of Congenital Heart Disease: A Novel Screening Protocol Improves Early Diagnosis of Complex Congenital Heart Disease","volume":"37","author":"Letourneau K. M.","year":"2018","journal-title":"Journal of Ultrasound in Medicine"},{"issue":"1","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1186\/s12884-021-04028-5","article-title":"Prenatal Detection of Congenital Heart Disease\u2014Results of a Swedish Screening Program 2013\u20102017","volume":"21","author":"Waern M.","year":"2021","journal-title":"BMC Pregnancy and Childbirth"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.886262","article-title":"Prenatal Detection of Congenital Heart Diseases Using Echocardiography: 12\u2010Year Results of an Improving Program With 9782 Cases","volume":"10","author":"Ou Y.","year":"2022","journal-title":"Frontiers in Public Health"},{"issue":"6","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1002\/uog.12312","article-title":"'I\u2010Shaped' Sign in the Upper Mediastinum: A Novel Potential Marker for Antenatal Diagnosis of d\u2010Transposition of the Great Arteries","volume":"41","author":"Ishii Y.","year":"2013","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"issue":"6","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1002\/uog.13357","article-title":"'Post\u2010LA Space Index' as a Potential Novel Marker for the Prenatal Diagnosis of Isolated Total Anomalous Pulmonary Venous Connection","volume":"44","author":"Kawazu Y.","year":"2014","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"issue":"7","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1007\/s00246-023-03197-8","article-title":"Impact of Prenatal Diagnosis of Critical Congenital Heart Disease on Preoperative and Postoperative Outcomes","volume":"44","author":"Dischinger A. N.","year":"2023","journal-title":"Pediatric Cardiology"},{"issue":"3","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00246-012-0504-4","article-title":"Prenatal Diagnosis of Congenital Heart Disease and Birth Outcomes","volume":"34","author":"Landis B. J.","year":"2013","journal-title":"Pediatric Cardiology"},{"issue":"11","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-018285","article-title":"Impact of Prenatal Diagnosis on Survival of Newborns With Four Congenital Heart Defects: A Prospective, Population\u2010Based Cohort Study in France (The EPICARD Study)","volume":"7","author":"Khoshnood B.","year":"2017","journal-title":"BMJ Open"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70467","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70467","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:12:52Z","timestamp":1782097972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70467"],"URL":"https:\/\/doi.org\/10.1111\/ped.70467","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70467"}}