Risk factors and repercussions on family dynamics of prenatal diagnosis of congenital heart disease

Abstract

Introduction: congenital heart defects are the most common congenital anomaly, with a global prevalence of 8 to 12 per 1,000 live births. This study evaluated risk factors and family repercussions associated with the prenatal diagnosis of congenital heart defects in the catchment areas of the Aleida Fernandez, Cristobal Labra, and Elpidio Berovides polyclinics, from the perspective of Primary Health Care.

Objective: to identify the risk factors associated with the prenatal diagnosis of congenital heart disease in pregnant women treated in three polyclinics in the municipality of La Lisa, Cuba, during 2024.

Methods: a descriptive cross-sectional study (2024) was conducted across 18 medical offices within three polyclinics (n = 360 pregnant women; stratified sampling). The instruments employed included a WHO-adapted survey, the FAD Scale (α = 0,89), and Doppler ultrasound (87% sensitivity). Data analysis involved descriptive statistics, Pearson correlation (r), and Odds Ratios (OR) (SPSS v.26; p < 0,05).

Results: the prevalence of congenital heart defects was 9.2% (n = 33; 55% of which were septal defects). Identified risk factors included maternal age >35 years (OR 3,1; 95% CI: 1,8–5,4) and smoking (r = 0,45; p < 0,01). Regarding family dynamics, the mean FAD score was 2,6 ± 0,9 in cases versus 1,9 ± 0,7 in controls (difference of means: 0.7; p < 0.001); economic stress was reported in 70% of cases (OR 3,5). Early detection within the PHC setting reached 65% and resulted in a 28% reduction in anxiety levels.

Conclusions: prenatal congenital heart defects were found to correlate with modifiable risk factors and were associated with disruptions in family cohesion. Primary Health Care facilitated early detection and support, thereby mitigating the negative impact in 30% of cases; the implementation of comprehensive programs is recommended.