Routine prenatal screening for congenital heart disease: what can be expected? A decision-analytic approach
OBJECTIVES: This study assessed the potential impact of fetal ultrasound screening on the number of newborns affected by cardiac anomalies. METHODS: A decision model was developed that included the prevalence and history of congenital heart disease, characteristics of ultrasound, risk of abortion, and attitude toward pregnancy termination. Probabilities were obtained with a literature survey; sensitivity analysis showed their influence on expected outcomes. RESULTS: Presently, screening programs may prevent the birth of approximately 1300 severely affected newborns per million second-trimester pregnancies. However, over 2000 terminations of pregnancy would be required, 750 of which would have ended in intrauterine death or spontaneous abortion. Further, 9900 false-positive screening results would occur, requiring referral. Only the sensitivity of routine screening and attitude toward termination of pregnancy appeared to influence the yield substantially. CONCLUSIONS: The impact of routine screening for congenital heart disease appeared relatively small. Further data may be required to fully assess the utility of prenatal screening.
|Keywords||*Mass Screening, *Prenatal Diagnosis, Abortion, Spontaneous, Attitude, Decision Support Techniques, Diagnostic Tests, Routine, Female, Heart Defects, Congenital/*diagnosis/ultrasonography, Humans, Multivariate Analysis, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Sensitivity and Specificity, Ultrasonography, Prenatal|
Buskens, E., Steyerberg, E.W., Hess, J., Wladimiroff, J.W., & Grobbee, D.E.. (1997). Routine prenatal screening for congenital heart disease: what can be expected? A decision-analytic approach. American Journal of Public Health. Retrieved from http://hdl.handle.net/1765/8703