Funding outcome

Congenital heart disease (CHD), the most common birth defect, affects 1/100 babies. The prenatal (before birth) diagnosis of CHD reduces infant morbidity and mortality. A prenatal diagnosis results in improved care of both the pregnant mother and the affected baby through appropriate pregnancy care, counselling, better delivery planning, preparation for future surgeries, and postnatal (after birth) care. The timing of the diagnosis during pregnancy is critical as an earlier diagnosis allows for more options for the mother, including consideration of termination, and increases accuracy of diagnosis. We have previously shown that patients in Alberta who live outside Edmonton or Calgary have a higher risk of missed and late prenatal diagnosis of CHD. Thus, despite universal healthcare, there seems to be inequalities in accessing healthcare services, but it is uncertain where health system modifications might be targeted. Therefore, the aim of this retrospective study is to identify health system factors influencing the rate and timing of prenatal CHD diagnosis, and possible association of these factors with SES and residential location. In a population of cases with major CHD, we will identify gestation at first obstetric ultrasound and the number of ultrasounds between first scan and referral to fetal cardiology. We will be examining major CHD, (requiring surgery within the first year of life), from 2015-2019, (approximately 500 cases, of which 60% had a prenatal diagnosis). Time-permitting, we will also include cases from 2019-2022 to consider the additional factor of COVID-19, and earlier than 2015. Findings from this research will promote a healthier future by helping to ensure good quality and timely ultrasound screening of the fetus is available for all pregnant mothers, including those from from lower SES and non-metropolitan communities.