Background:There is no consensus on the effectiveness of prenatal diagnosis except for hospitalized outcomes.Hence,a meta-analysis of published literature was conducted to assess the effect of prenatal diagnosis.Metho...Background:There is no consensus on the effectiveness of prenatal diagnosis except for hospitalized outcomes.Hence,a meta-analysis of published literature was conducted to assess the effect of prenatal diagnosis.Methods:Literature review has identified relevant studies up to December 2013.A meta-analysis was performed according to the guidelines from the Cochrane review group and the PRISMA statement.Studies were identified by searching PubMed,Embase,the Cochrane Central Register of Controlled Trials and World Health Orgnization clinical trials registry center.Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1 according to the guidelines from the Cochrane review group and the PRISMA guidelines.Results:The results from 13 cohort studies in 12 articles were analyzed to determine the optimal treatment with the lower rate of perioperative mortality in prenatal diagnosis.The superiority of a prenatal diagnosis has been proven because the surgical procedure could be done in the early neonatal period(95%CI,-0.76,-0.40).The prenatal diagnosis has also remarkably reduced the preoperative and postoperative mortality rates in cases of transposition of the great arteries(95% CI=0.06,0.80;95%CI=0.01,0.82,respectively),as well as the overall results with all subtypes(95% CI=0.18,0.94;95% CI=0.46,0.94,respectively).Conclusions:Prenatal diagnosis is effective in perinatal management with an earlier intervention for major congenital heart disease,but only results in a reduced perioperative mortality in cases of transposition of the great arteries.Further investigations are required to evaluate the effect of prenatal diagnosis on life quality during a long-term follow-up.展开更多
基金This work was supported by grants from the National Natural Science Foundation of China(No.81070136)the Program for Yangtze River Scholars and Innovative Research Team in University(No.IRT0935).
文摘Background:There is no consensus on the effectiveness of prenatal diagnosis except for hospitalized outcomes.Hence,a meta-analysis of published literature was conducted to assess the effect of prenatal diagnosis.Methods:Literature review has identified relevant studies up to December 2013.A meta-analysis was performed according to the guidelines from the Cochrane review group and the PRISMA statement.Studies were identified by searching PubMed,Embase,the Cochrane Central Register of Controlled Trials and World Health Orgnization clinical trials registry center.Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1 according to the guidelines from the Cochrane review group and the PRISMA guidelines.Results:The results from 13 cohort studies in 12 articles were analyzed to determine the optimal treatment with the lower rate of perioperative mortality in prenatal diagnosis.The superiority of a prenatal diagnosis has been proven because the surgical procedure could be done in the early neonatal period(95%CI,-0.76,-0.40).The prenatal diagnosis has also remarkably reduced the preoperative and postoperative mortality rates in cases of transposition of the great arteries(95% CI=0.06,0.80;95%CI=0.01,0.82,respectively),as well as the overall results with all subtypes(95% CI=0.18,0.94;95% CI=0.46,0.94,respectively).Conclusions:Prenatal diagnosis is effective in perinatal management with an earlier intervention for major congenital heart disease,but only results in a reduced perioperative mortality in cases of transposition of the great arteries.Further investigations are required to evaluate the effect of prenatal diagnosis on life quality during a long-term follow-up.
