Rose He

Supervisor: Luke Eckersley

Project: Factors that affect prenatal diagnosis of major heart defects

“An earlier diagnosis of congenital conditions can benefit both the mother and child through better family counselling and optimizing care, leading to a happier and healthier future.”

Congenital heart disease (CHD), the most common birth defect, affects one in every 100 babies and can cause lifelong disability or death. 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 care. The timing of the diagnosis during pregnancy is critical; an earlier diagnosis allows for more options for the mother, including consideration of termination, and increases the 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. Despite universal healthcare, there seem to be inequalities in accessing healthcare services. We are not sure where to target changes in the health system to address the inequalities. The aim of this study is to identify health system factors influencing the rate and timing of prenatal CHD diagnosis, and the possible association of these factors with the patient’s socioeconomic status and residence location.  

We will look at cases of patients with major CHD (requiring surgery within the first year of life) to identify fetal age at the first obstetric ultrasound and the number of ultrasounds between the first scan and referral to specialized fetal cardiology screening. We will examine cases from 2015-2019, approximately 500 cases, of which 60 per cent had a prenatal diagnosis. Time permitting, we will also include cases earlier than 2015 and from 2019-2022 to consider the additional factor of COVID-19. 

Findings from this research will promote a healthier future by helping to ensure that good quality and timely ultrasound screening of the fetus is available for all pregnant mothers, including those from lower socioeconomic status and non-metropolitan communities.

Rose He was supervised by Luke Eckersley and her summer studentship was funded by the Stollery Children’s Hospital Foundation. She is enrolled in the Bachelor of Science with Honors in Physiology program.