The Pandemic Effect: Secondary Impact on the Diagnosis of Clinically Significant Congenital Heart Disease and Role of Deprivation Index

TL;DR

The study found that the pandemic did not significantly affect the prenatal diagnosis of serious heart defects in infants, but socioeconomic factors played a complex role.

Contribution

The study uniquely compares two socioeconomic metrics to understand their impact on prenatal diagnosis during the pandemic.

Findings

There was no significant difference in prenatal diagnosis rates of CHD during and before the pandemic.

Higher socioeconomic status groups showed conflicting results depending on the metric used.

Lower socioeconomic groups had consistent prenatal diagnosis rates regardless of the pandemic.

Abstract

We sought to determine the impact of the COVID-19 on prenatal diagnosis (PND) of clinically significant congenital heart disease (CHD) and the role of socioeconomic status (SES), complexity of diagnosis, and proximity to advance testing. This single-center retrospective study evaluated 2 eras of infants (COVID (born July 1, 2020–July 31, 2023) and pre-COVID (born June 1, 2017–July 1, 2020) who had cardiac surgery in the first year of life. 512 infants, 292 in pre-COVID era and 220 in COVID era with no significant difference in the rate of prenatal care (PNC) or PND in the COVID era (88%/42%) versus pre-COVID era (93%/48%) (χ2 = 3.22, p = 0.07, χ2 = 1.9, p = 0.17). Distance from advanced testing had no influence on PND in the COVID era [55% close versus 53% further away (χ2 = 2, p = 0.65)]. When evaluating SES with income per zip code, the higher SES group had increased PND during the pandemic compared to both pre-COVID era and low SES group. However, social deprivation index (SDI) based on zip code showed the higher SES group had a decrease in PND rates. Both metrics showed no change in PND in the lower SES group during COVID. COVID-19 had no significant change in the PND of clinically significant CHD during the pandemic. The differing SES results using income versus SDI of patient zip codes suggest that barriers to PND is multifactorial. The discrepancy in PND reflects poor referral rates to advanced testing, highlighting the importance of educating frontline healthcare professionals to improve outcomes.

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