{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:07:58Z","timestamp":1771459678009,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,1,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Norwood surgery provides a palliative surgical option for hypoplastic left heart syndrome and has been available in Sweden since 1993. The practice of prenatal ultrasound screening was gradually implemented in the same era, resulting in an increased prenatal detection rate. Our primary aims were to study changes in the incidence of live births, prenatal detection rate, and the termination of pregnancies over time. The secondary aims were to study the proportion of live\u2010borns undergoing surgery and to identify factors that influenced whether surgery was or was not performed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Neonates with hypoplastic left heart syndrome with aortic atresia born 1990\u20102010 were identified through national databases, surgical files, and medical records. The fetal incidence was estimated from the period when prenatal screening was rudimentary. The study period was divided into the presurgical, early surgical, and late surgical periods. The incidence was calculated as the overall yearly incidence for each time period and sex separately. Factors influencing whether surgery was performed were analyzed using Cox\u2010logistic regression. The incidence at live birth decreased from 15.4 to 8.4 per 100\u00a0000. The prenatal detection rate increased from 27% to 63%, and terminations increased from 19% to 56%. The odds of having surgery was higher in the late period and higher in the group with prenatal diagnosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">We observed a decrease in incidence of live\u2010borns with hypoplastic left heart syndrome aortic atresia. There was in increase in prenatal detection rate and an increase in termination of pregnancy. The proportion of live\u2010borns who underwent surgery increased between time periods.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010893","type":"journal-article","created":{"date-parts":[[2019,1,19]],"date-time":"2019-01-19T10:01:28Z","timestamp":1547892088000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Changing Epidemiology of Hypoplastic Left Heart Syndrome: Results of a National Swedish Cohort Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Annika","family":"\u00d6hman","sequence":"first","affiliation":[{"name":"Department of Paediatric Cardiology Queen Silvia Children\u2032s Hospital Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milad","family":"El\u2010Segaier","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarina","family":"Hans\u00e9us","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Malm","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Queen Silvia Children\u2032s Hospital Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldina","family":"Pivodic","sequence":"additional","affiliation":[{"name":"Statistiska konsultgruppen Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Rydberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Paediatrics Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven\u2010Erik","family":"Sonesson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mats","family":"Mellander","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Queen Silvia Children\u2032s Hospital Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.07.030"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20169"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02083294"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159257"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.1976.tb01571.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.21.1.40"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900502"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2008.01152.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2016.05.04"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-016-1455-y"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12382"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.79.4.371"},{"key":"e_1_3_2_14_2","first-page":"899","article-title":"Improved prenatal diagnosis of congenital heart defects. 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