Impact of the time of diagnosis on the postoperative outcome of newborn infants with congenital heart disease in a public hospital in Argentina

Congenital heart diseases account for 13% of child mortality, and late diagnosis increases morbidity and mortality. The objective of this study was to assess the impact of the time of diagnosis in newborn infants on the postoperative course. The time of diagnosis was classified into prenatal, before or after discharge from the maternity center. Two hundred ninety-nine patients were included; their gestational age was 38 ± 2.6 weeks and their birth weight was 3.22 ± 0.6 kg. Two hundred sixty-six patients underwent surgery, 13 were excluded due to the characteristics of the lesion, and 10 because of hemodynamic collapse, while 10 were treated at the Cath Lab or were operated beyond the neonatal period. Only 19 patients (7%) were diagnosed before birth; most were patients who had health insurance, lived in the City of Buenos Aires or in capital cities of other provinces. The time of diagnosis was not associated with differences in mortality; however, an association was observed with a poor preoperative clinical status, with 3.6% of patients who died before surgery. Postoperative survival was 89.5%; overall survival was 83%.