{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:17:52Z","timestamp":1784819872591,"version":"3.55.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Fetal echocardiography is the mainstay of prenatal diagnosis of congenital heart disease. The COVID\u201019 pandemic led to shifts in triage of prenatal services. Our objective was to evaluate the impact of COVID\u201019 restrictions on prenatal diagnosis, surgical outcomes, and disparities in neonatal critical congenital heart disease (CCHD) management in the United States during the pandemic's first year.<\/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\">\n                      A multi\u2010institutional retrospective cohort study compared neonatal CCHD outcomes (requiring surgery within 60\u2009days of birth) 1 year prior (prepandemic era) and during the peak pandemic era, supplemented by a Fetal Heart Society survey assessing regional practice changes. Data on prenatal diagnosis, demographics, outcomes, and 2020 state Area Deprivation Index were analyzed using Wilcoxon rank sum and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests. The survey, completed by 72 fetal cardiologists from 9 US census regions, showed 75% of institutions implemented restrictions by March 2020, affecting triage, referrals, and number of prenatal cardiology visits. Compared with CCHD neonates born prepandemic (n=4637), those born during the pandemic (n=1806) had a higher proportion of prenatal diagnosis (66% versus 63%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05). There were no significant differences in complications or mortality, but pandemic\u2010era neonates had longer hospital stays. During the pandemic, CCHD neonates had a more disadvantaged Area Deprivation Index and had surgery at hospitals located in more advantaged regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although pandemic\u2010driven care delivery adjustments affected perinatal cardiology referrals and triage, prenatal diagnosis, perioperative outcomes, and survival remained robust. The management of CCHD demonstrates health care resilience, maintaining core prenatal and perioperative care. Regional variations highlight the need for targeted strategies to address disparities during health care crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037079","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:00:41Z","timestamp":1746172841000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of COVID\u201019 on Prenatal Diagnosis and Surgical Outcomes of Congenital Heart Disease: Fetal Heart Society and Society of Thoracic Surgeons Collaborative Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-5396","authenticated-orcid":false,"given":"Bhawna","family":"Arya","sequence":"first","affiliation":[{"name":"Seattle Children\u2019s Hospital and the University of Washington School of Medicine","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-4694","authenticated-orcid":false,"given":"Miza Salim","family":"Hammoud","sequence":"additional","affiliation":[{"name":"Cleveland Clinic","place":["Cleveland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8373-0559","authenticated-orcid":false,"given":"Andrew J.","family":"Toth","sequence":"additional","affiliation":[{"name":"Cleveland Clinic","place":["Cleveland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-4903","authenticated-orcid":false,"given":"Joyce","family":"Woo","sequence":"additional","affiliation":[{"name":"Ann & Robert H. 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