In cases of mild congenital heart defects, more prenatal visits are associated with a greater likelihood of an appropriate delivery in a community hospital, according to a study published in JAMA Network Open. The results suggest that more prenatal care is beneficial for families and may allow their newborns with mild heart defects to receive the right level of care closer to home, as opposed to traveling to a regional heart surgery center, which can be expensive, burdensome and stressful for families.
Congenital heart defects are the most common and resource intensive in the United States. Infants with the most complex heart defects are usually directed to regional heart surgery centers, while babies with mild heart defects can safely receive proper care at a community hospital.
Our findings highlight the importance of prenatal care in promoting the use of appropriate care for newborns with heart defects. A prenatal visit is usually not enough, as fetal heart disease can change during pregnancy. It may turn out to be less serious than first suspected. If the newborn does not need surgery right away, then staying closer to home for the birth may be the right decision. Many families may prefer it. Risk-appropriate care also benefits the overall health care system.”
Joyce Woo, MD, MS, senior author, pediatric cardiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics and Medical Social Sciences at Northwestern University Feinberg School of Medicine
In the study, Dr. Wu and colleagues used a statewide administrative database to analyze data on 12,113 babies born with heart defects in Illinois between 2013-2021. Their aim was to assess how two components of prenatal care adequacy – initiation of care and frequency of visits – relate to place of delivery for newborns with congenital heart defects.
They found that delayed initiation of prenatal care was associated with an increased likelihood of delivery in a cardiac surgery center compared with no prenatal care, regardless of the severity of the heart defect. But for babies with mild congenital heart defects, more prenatal visits were associated with a 7 percentage point reduction in the likelihood of delivery in a cardiac surgery center.
“Care for children with heart defects begins before birth. Prenatal care ensures that babies with congenital heart defects are born in the right location with the appropriate intensity of care based on their clinical needs. It also allows for consideration of their family’s preferences for place of delivery,” said Dr. Wu. “Our findings can also help inform statewide policy on perinatal resource allocation.”
This analysis will be presented at the American Heart Association Scientific Sessions on November 9, 2025.
Dr. Woo receives salary support from the National Institutes of Health (NIH/NHLBI K01HL171819).
