Journal of Perinatal Medicine最新文献

{"title":"Effects of a respiratory function indicator light on visual attention and ventilation quality during neonatal resuscitation: a randomised controlled crossover simulation trial.","authors":"Yasuhisa Ikuta, Fumihiko Takatori, Shoichiro Amari, Ai Ito, Akira Ishiguro, Tetsuya Isayama","doi":"10.1515/jpm-2024-0251","DOIUrl":"10.1515/jpm-2024-0251","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effectiveness of placing an indicator light indicating inadequate ventilation near the face mask during positive-pressure ventilation with respiratory function monitors (RFMs) in neonatal resuscitation. The study is a three-group, randomised, controlled, crossover simulation trial.</p><p><strong>Methods: </strong>Paediatrics residents, neonatology fellows, and attending neonatologists at a single neonatal intensive care unit. A ventilation simulation with a manikin was performed three times consecutively using the same scenario with three different ventilation evaluation methods (A) RFM plus indicator light and conventional methods (heart rate and chest rise) (B) RFM and conventional methods, and (C) conventional methods alone.</p><p><strong>Results: </strong>The ratio of gaze duration on the manikin to the total trial duration was recorded using an eye-tracking device. The proportion of trials with adequate ventilation (expiratory tidal volume [VTe], 4-10 mL/kg; peak inspiratory pressure <30 cm H₂O; leak <40 %) was determined. After excluding incomplete data, 63 simulations (22 participants) were analysed. The ratios of the gaze duration on the manikin to the total trial duration were significantly different among settings A (0.60 [95 % confidence interval: 0.52-0.67] s/s), B (0.51 [0.43-0.59] s/s), and C (0.80 [0.76-0.84] s/s). Ventilation with adequate VTe and less leakage was more frequent in settings A and B than in setting C (adequate VTe: A, 91 %; B, 91 %; and C, 83 %; less leak: A, 76 %; B, 78 %; and C, 57 %).</p><p><strong>Conclusions: </strong>An indicator light close to the facemask with an RFM directed the eyesight towards the manikin without compromising the ventilation quality during the simulation of neonatal resuscitation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"249-257"},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of a non-invasive vaginal tool to assess the risk of intra-amniotic inflammation in pregnant women with preterm labor and intact membranes.","authors":"Teresa Cobo, Xavier P Burgos-Artizzu, Silvia Ferrero, Judith Balcells, Jordi Bosch, Amadeu Gené, Clara Murillo, Claudia Rueda, David Boada, Maria Teresa Sánchez-Antón, Marian Kacerovsky, Bo Jacobsson, Montse Palacio","doi":"10.1515/jpm-2024-0178","DOIUrl":"10.1515/jpm-2024-0178","url":null,"abstract":"<p><strong>Objectives: </strong>To prospectively validate the diagnostic performance of a non-invasive point-of-care tool (Rapid IAI System), including vaginal alpha-fetoprotein and interleukin-6, to predict the occurrence of intra-amniotic inflammation in a Spanish cohort of patients admitted with a diagnosis of preterm labor and intact membranes.</p><p><strong>Methods: </strong>From 2017 to 2022, we prospectively evaluated a cohort of pregnant women diagnosed with preterm labor and intact membranes admitted below 34+0 weeks who underwent amniocentesis to rule-in/out intra-amniotic infection and/or inflammation. Vaginal sampling was performed at the time of amniocentesis or within 24-48 h. Amniotic fluid IL-6, vaginal alpha-fetoprotein and vaginal IL-6 concentrations were measured using a point-of-care tool provided by Hologic Inc., \"Rapid IAI System\". We defined intra-amniotic inflammation when amniotic fluid IL-6 values were greater than 11.3 ng/mL. During recruitment, clinicians were blinded to the results of the point-of-care tool. The original prediction model proposed by Hologic Inc. to predict intra-amniotic inflammation was validated in this cohort of patients.</p><p><strong>Results: </strong>We included 151 patients diagnosed with preterm labor and intact membranes. Among these, 29 (19.2 %) had intra-amniotic inflammation. The algorithm including vaginal IL-6 and alpha-fetoprotein showed an area under curve to predict intra-amniotic inflammation of 80.3 % (±5.3 %) with a sensitivity of 72.4 %, specificity of 84.6 %, positive predictive valuve (PPV) of 52.5 %, negative predictive value (NPV) of 92.9 %, and a positive likelihood ratio (LR+) of 4.6 and negative likelihood ratio (LR-) of 0.33.</p><p><strong>Conclusions: </strong>External validation of a non-invasive rapid point-of-care tool, including vaginal alpha-fetoprotein and IL-6, showed very good diagnostic performance for predicting the absence of intra-amniotic inflammation in women with preterm labor and intact membranes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"170-178"},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of ultrasound spectra of middle cerebral artery and umbilical artery blood flow in adverse pregnancy outcomes.","authors":"Xuan Zhao, Ya Shen","doi":"10.1515/jpm-2024-0323","DOIUrl":"10.1515/jpm-2024-0323","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic value of ultrasound spectra of the middle cerebral artery (MCA) and umbilical artery (UA) blood flow in predicting adverse pregnancy outcomes.</p><p><strong>Methods: </strong>Data from 202 late singleton pregnancies (32-34 weeks gestation) were analyzed. Group A included 155 normal pregnancies, while Group B comprised 47 high-risk pregnancies. Color Doppler ultrasonography was used to measure and compare pulsatility index (PI), resistance index (RI), and end-systolic peak/end-diastolic peak (S/D) ratios of fetal MCA and UA between the groups.</p><p><strong>Results: </strong>UA-related parameters (PI, RI, and S/D) were significantly higher in Group B compared to Group A, whereas MCA-related parameters (PI, RI, and S/D) were significantly lower in Group B than in Group A. In pregnancies with adverse outcomes, fetal UtA and UA-related parameters were elevated, while MCA parameters were decreased compared to those with favorable outcomes.</p><p><strong>Conclusions: </strong>Ultrasound spectra of MCA and UA blood flow provide valuable clinical information for assessing fetal intrauterine growth and predicting adverse pregnancy outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"234-241"},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A family-centric, comprehensive nurse-led home oxygen programme for neonatal chronic lung disease: home oxygen policy evaluation (HOPE) study.","authors":"Nele Legge, Dominic Fitzgerald, Jacqueline Stack, Himanshu Popat","doi":"10.1515/jpm-2024-0319","DOIUrl":"10.1515/jpm-2024-0319","url":null,"abstract":"<p><strong>Objectives: </strong>Considerable variation and little objective evidence exists to guide the use of supplemental oxygen therapy in infants with neonatal chronic lung disease (nCLD) after hospital discharge. We developed a new policy utilizing regular oximetry downloads to help determine commencement and titration of low flow oxygen. The aim of this policy is to improve safety and uniformity in practice and potentially lead to improvements in outcomes including the number of infants being discharged on home oxygen therapy (HOT) and length of stay (LOS).</p><p><strong>Methods: </strong>This single-centre pre- and post-implementation study included 86 and 94 infants <32 weeks' gestation (pre- vs. post-implementation) meeting definition of nCLD. The primary outcomes were (1) successful implementation of the new policy, (2) changes in number of patients discharged on HOT and (3) in LOS. Secondary outcomes were changes in feeding mode at discharge, total length of HOT, readmission to hospital within the first year of life and neurodevelopmental outcomes at 8 months post menstrual age amongst infants treated with HOT.</p><p><strong>Results: </strong>The policy was successfully implemented with 100 % of infants with nCLD receiving downloads in the post-implementation epoch. Pre-implementation 36 % (31 of 85) of infants with nCLD were treated with HOT vs. 17 % (16 of 94) post-implementation (p=0.03). There was no significant difference in LOS or any of the secondary outcomes.</p><p><strong>Conclusions: </strong>A protocolised approach to decision making using predetermined parameters regarding the need for supplemental oxygen in neonates with nCLD is practical and achievable and may result in fewer neonates requiring HOT.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"242-248"},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and fetal outcomes among pregnant women with endometriosis.","authors":"Sara Abdessamie, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim","doi":"10.1515/jpm-2024-0359","DOIUrl":"10.1515/jpm-2024-0359","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis, a condition in which endometrial-like tissue grows outside of the uterus, is a common disorder among women of reproductive-age. The objective of the study is to examine the associations between endometriosis in pregnancy and adverse maternal and newborn events.</p><p><strong>Methods: </strong>Data from the 1999-2019 Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, which is from the United States, were used to perform a retrospective cohort study. Associations between endometriosis and maternal and newborn outcomes were examined using multivariate logistic regression models adjusted for baseline maternal characteristics.</p><p><strong>Results: </strong>We identified 14,956 individuals with endometriosis and 16,911,497 individuals without endometriosis. The prevalence of endometriosis in pregnancy rose substantially from 34.9 to 160.6 per 100,000 births between 1999 and 2019. Individuals with endometriosis were more likely older in age, of Caucasian ethnicity, belonged to higher income quartiles, had private insurance, smoked, and were obese. Endometriosis in pregnancy was associated with greater odds of pre-eclampsia, gestational diabetes, placenta previa, placental abruption, preterm birth, chorioamnionitis, and postpartum hemorrhage. Growth restriction and congenital anomalies were more frequent among newborns born to individuals with endometriosis.</p><p><strong>Conclusions: </strong>Endometriosis in pregnancy renders individuals and their newborns at greater risk for poor outcomes in pregnancy. Hence, it is prudent for obstetrical care providers to be aware of the adverse events associated with endometriosis and to closely follow the pregnancies of women with this condition.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"32-38"},"PeriodicalIF":1.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The early COVID-19 pandemic period and associated gestational weight gain.","authors":"Ayomipo Madein, Lisbet Lundsberg, Jennifer Culhane, Caitlin Partridge, Moeun Son, Audrey Merriam","doi":"10.1515/jpm-2024-0088","DOIUrl":"10.1515/jpm-2024-0088","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate if gestational weight gain was altered during the early COVID-19 pandemic period.</p><p><strong>Methods: </strong>This a retrospective cohort study evaluating gestational weight gain among individuals delivering during the early COVID-19 pandemic epoch (March 10-December 31, 2020) compared to temporally matched pre-pandemic (matched months in 2018 and 2019) controls using electronic medical record data from a large tertiary care hospital. The primary outcome was gestational weight gain defined as a categorical measure representing below, meeting, or above Institute of Medicine (IOM) criteria with further adjustment for gestational age at delivery. The early-pandemic exposure group was also categorized by gestational age at the start period (<14 weeks' and 14-20 weeks') to assess if duration of exposure affected gestational weight gain risks with the use of multinominal logistic regression.</p><p><strong>Results: </strong>Among 5,377 individuals 3,619 (67.3 %) and 1,758 (32.7 %) were in the pre and early pandemic epochs respectively. Overall, 934 (17.4 %) individuals gained below recommended, 1,280 (23.8 %) met recommendations, and 3,163 (58.8 %) gained above IOM recommended gestational weight gain. Compared to the pre-pandemic epoch, the early pandemic period was not associated with weight gain below (OR 1.06, 95 % Cl 0.89-1.27) or above (OR 1.03, 95 % Cl 0.89-1.19) IOM recommendations. This was also true when the early pandemic group was stratified based on gestational age at the start of the early pandemic period (<14 weeks' and 14-20 weeks').</p><p><strong>Conclusions: </strong>This study demonstrated no significant difference in maternal weight gain between pre and early COVID-19 pandemic periods.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"2-8"},"PeriodicalIF":1.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse perinatal outcomes related to pregestational obesity or excessive weight gain in pregnancy.","authors":"Antonia A D Oliveira, Tassiana C M Grabovski, Carla C Renzo, Leonardo S Carvalho, Fabiana B Nerbass, Jean C Silva","doi":"10.1515/jpm-2024-0181","DOIUrl":"10.1515/jpm-2024-0181","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate outcomes related to pregestational obesity and excessive weight gain during pregnancy.</p><p><strong>Methods: </strong>This retrospective cohort was conducted from August to December 2020. Participants were divided into four groups: non-obese with non-excessive weight gain (n=765, 45.9 %), obese with non-excessive weight gain (n=190, 11.4 %), non-obese with excessive weight gain (n=532, 31.9 %), and obese with excessive weight gain (n=179, 10.7 %). The outcomes were evaluated for gestational diabetes (GDM), pregnancy-induced hypertension (PIH), newborn large for gestational age (LGA) and cesarean delivery. A p-value of <0.05 was considered significant.</p><p><strong>Results: </strong>The odds of GDM were significant in groups 2 (CR, 3.6; 95 %CI, 2.5-5.2) and 4 (CR,1.9; 95 %CI, 1.3-2.9). The odds of PIH in groups 3 (CR, 1.7; 95 %CI, 1-2.6) and 4 (CR,3.1; 95 %CI, 1.9-5.2) and those of LGA newborns in groups 2 (CR, 2.0; 95 %CI, 1.2-3.3), 3 (CR, 2.6; 95 %CI, 1.9-3.7), and 4 (CR, 3.2; 95 %CI, 2-5) were high.</p><p><strong>Conclusions: </strong>The odds of GDM were higher in participants with pregestational obesity, while the odds of PIH were higher in participants with excessive weight gain. All groups analyzed, except the reference group, had greater chances of LGA newborns. the form of delivery was not affected.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"25-31"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing patient understanding in obstetrics: The role of generative AI in simplifying informed consent for labor induction with oxytocin.","authors":"Amos Grünebaum, Joachim Dudenhausen, Frank A Chervenak","doi":"10.1515/jpm-2024-0428","DOIUrl":"10.1515/jpm-2024-0428","url":null,"abstract":"<p><p>Informed consent is a cornerstone of ethical medical practice, particularly in obstetrics where procedures like labor induction carry significant risks and require clear patient understanding. Despite legal mandates for patient materials to be accessible, many consent forms remain too complex, resulting in patient confusion and dissatisfaction. This study explores the use of Generative Artificial Intelligence (GAI) to simplify informed consent for labor induction with oxytocin, ensuring content is both medically accurate and comprehensible at an 8th-grade readability level. GAI-generated consent forms streamline the process, automatically tailoring content to meet readability standards while retaining essential details such as the procedure's nature, risks, benefits, and alternatives. Through iterative prompts and expert refinement, the AI produces clear, patient-friendly language that bridges the gap between medical jargon and patient comprehension. Flesch Reading Ease scores show improved readability, meeting recommended levels for health literacy. GAI has the potential to revolutionize healthcare communication by enhancing patient understanding, promoting shared decision-making, and improving satisfaction with the consent process. However, human oversight remains critical to ensure that AI-generated content adheres to legal and ethical standards. This case study demonstrates that GAI can be an effective tool in creating accessible, standardized, yet personalized consent documents, contributing to better-informed patients and potentially reducing malpractice claims.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first 2-year prospective audit of prenatal cell-free deoxyribonucleic screening using single nucleotide polymorphisms approach in a single academic laboratory.","authors":"Tachjaree Panchalee, Naravat Poungvarin, Warisa Amornrit, Chutima Yaiyiam, Tuangsit Wataganara","doi":"10.1515/jpm-2024-0339","DOIUrl":"10.1515/jpm-2024-0339","url":null,"abstract":"<p><strong>Objectives: </strong>We reported a performance during an implementation of prenatal cell-free (cf) DNA screening using single nucleotide polymorphism (SNP) approach in our accredited laboratory.</p><p><strong>Methods: </strong>Prospective audit with prompt intervention was set for the processing of 2,502 samples from singleton pregnancy from August 2017 to July 2019. Risks of trisomy 21 (T21), T18, T13, monosomy X (XO), and other sex chromosome aneuploidies (SCAs) were clarified by a proprietary bioinformatics algorithm.</p><p><strong>Results: </strong>Laboratory failure occurred in 192 samples (7.7 %) as a result of inadequate sequencing (n=144), fundamental limitation of the testing (n=19), and obvious human error (n=29). Faulty setting of the calibration curve was the most common human error (n=22/29). After a redraw (n=110), 79 (71.8 %) were settled. Overall, 2,389/2,502 samples (95.5 %) were reportable. Thirty-five samples were high-risk for T21 (n=19), T18 (n=5), T13 (n=1), XO (n=3), and other SCAs (n=7), respectively. Positive predictive values calculated from either prenatal confirmatory tests or postnatal findings were 93.8 % (n=16), 100 % (n=4), 50 % (n=2), and 83.3 % (n=6) for T21, T18, XO, and other SCAs, respectively, with high sensitivity and specificity (>99.9 %). Vanishing twin was detected from 1 out of 4 samples with detected additional haplotypes.</p><p><strong>Conclusions: </strong>An overall performance of SNP-based prenatal cf-DNA screening during our initial implementation can be optimized with proactive approach. The technical know-how was a significant limiting factor for adopting the technology. The lessons learnt may be of interest to the academic laboratory considering adopting their own test instead of sending blood to a testing service of a supplier.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"73-79"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary prenatal diagnosis of congenital heart disease in a regional perinatal center lacking onsite pediatric cardiac surgery: obstetrical and neonatal outcomes.","authors":"Deena Elkafrawi, Danielle Passafiume, Michelle Blomgren, Pamela Parker, Steven Gross, Frank Smith, Robert Silverman, Dimitrios Mastrogiannis","doi":"10.1515/jpm-2024-0153","DOIUrl":"10.1515/jpm-2024-0153","url":null,"abstract":"<p><strong>Objectives: </strong>Determine obstetrical and neonatal outcomes in neonates with major congenital heart disease (CHD) delivered at a level IV neonatal intensive care units (NICU) center lacking onsite pediatric cardiac surgery.</p><p><strong>Methods: </strong>A 10-year retrospective review of all neonates admitted to our level IV NICU, with CHD between January 1st, 2011 and December 31st, 2021. Births and NICU charts were cross queried with those from our perinatal center which include pediatric cardiology records. Terminations and stillbirths were excluded.</p><p><strong>Results: </strong>A total of 285 neonates with major CHD and 78 with minor defects were included. In the major CHD group, 82.8 % had an isolated cardiac anomaly and 17.2 % had an extracardiac anomaly. Type of extracardiac anomaly had no impact on neonatal survival. Prenatal diagnosis of aneuploidy did not impact survival in major CHD. Truncus arteriosus had the highest NICU mortality at 34.0 % followed by hypoplastic left heart syndrome (HLHS) at 31.6 %. Double outlet right ventricle with transposition of the great vessels and interrupted aortic arch (both types) had a 25 % mortality. Neonates with truncus arteriosus and total anomalous pulmonary venous returns were likely to have 5-min Apgar score<7. Transfer rate of neonates with major CHD for cardiac surgery was 58.6 %. Of those 81.5 % were discharged home, 14.3 % expired before discharge, and 1 % were transferred elsewhere post-operatively for higher level of care.</p><p><strong>Conclusions: </strong>Neonates with major CHD can deliver safely at a level IV NICU lacking onsite pediatric cardiac surgery. Our neonatal mortality was high for HLHS and truncus arteriosus, however comparable to other centers with proximate pediatric cardiac surgery.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"58-66"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}