Evaluation of Integrated Service Strategy Based on Diagnosis of Duct-Dependent Congenital Heart Disease and Neonatal Mortality Data Analysis - Beijing, China, 2021-2022.

Abstract

Objective: Integrated congenital heart disease (CHD) services were implemented in Beijing in 2022. This study analyzed prenatal diagnosis patterns and neonatal mortality data for duct-dependent CHDs before and after implementation to provide insights for service optimization.

Methods: We conducted a retrospective analysis of 487 cases of duct-dependent CHDs identified through the Beijing Birth Defects Monitoring System from January 2021 to December 2022. The study population included fetuses and infants from 13 weeks gestation to one year after birth. Cases underwent descriptive analysis focusing on disease occurrence, diagnostic timing, and mortality outcomes.

Results: The prenatal diagnosis rate for duct-dependent CHDs increased from 93.39% in 2021 to 93.91% in 2022, while delayed diagnosis rates decreased from 4.28% to 3.91%. Genetic diagnosis rates improved from 27.92% to 31.94%. Live birth rates following prenatal diagnosis increased substantially from 28.75% to 40.28%. Outcomes varied significantly by CHD subtypes, with complete transposition of the great arteries with intact ventricular septum achieving an 82.14% live birth rate, while hypoplastic left heart syndrome cases resulted in no live births. Notably, neonatal mortality decreased markedly from 7.23% to 3.03%.

Conclusions: Beijing's integrated service model for CHDs has effectively strengthened the connection between secondary and tertiary prevention strategies, reduced unnecessary pregnancy terminations, and improved neonatal survival outcomes.