Short-Term Results of Early Detection of Critical Congenital Heart Disease

Abstract

Background

Critical congenital heart disease (CCHD) affects 1 in 400 newborns and requires early intervention to prevent neonatal mortality. In Peru, neonatal CCHD screening is primarily implemented in the capital, but its impact on patient outcomes remains unclear.

Objectives

The purpose of this study was to evaluate the short-term outcomes of an early CCHD-detection program at the National Maternal Perinatal Institute in Lima, Peru.

Methods

A retrospective cohort study included all newborns diagnosed with CCHD at National Maternal Perinatal Institute between January 2022 and December 2023. Data were extracted from medical records, including maternal demographics, neonatal characteristics, and referral times to the 2 existing surgical congenital heart disease centers in Lima. Survival status was assessed through national identification registry records. Time to transfer, delays, and survival rates were analyzed using descriptive statistics, Kaplan-Meier survival curves, and multivariable models.

Results

A total of 34 neonates were diagnosed with CCHD. The most common conditions were hypoplastic left heart syndrome (18%) and pulmonary atresia (18%). Median time from birth to transfer was 8 days for EsSalud and 16 days for Ministry of Health (MINSA) surgical centers. The main causes of delay were lack of bed availability and administrative barriers. One-year survival rates were 36.7% for MINSA referrals and 85.7% for EsSalud referrals.

Conclusions

Despite early CCHD detection, neonatal mortality remains high, particularly for patients referred to MINSA centers. These findings highlight the urgent need to optimize referral pathways and expand surgical capacity to improve survival outcomes.