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Cohort studyJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2026

Fetal Anatomic and Physiologic Predictors of Neonatal Hypoxia in D-Transposition of the Great Arteries: A Prospective, Multi-Center Study by the Fetal Heart Society Research Collaborative.

Joyce T Johnson, David Schidlow, Jacqueline Shuplock … Fetal Heart Society Research Collaborative

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CardiologyCohort study

Neonatal hypoxia occurred in 38% of infants with D-transposition of the great arteries.

Fetal Anatomic and Physiologic Predictors of Neonatal Hypoxia in D-Transposition of the Great Arteries: A Prospective, Multi-Center Study by the Fetal Heart Society Research Collaborative.

Joyce T Johnson et al. · Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2026

Background

Sensitive fetal prediction of acute neonatal compromise at birth following a prenatal diagnosis of dextro-transposition of the great arteries/intact ventricular septum (dTGA/IVS) remains challenging.

Purpose

Using a large multicenter prospectively collected cohort, we aimed to determine if fetal echocardiogram findings could sensitively and specifically predict neonatal hypoxia.

Methods

Twenty-three centers enrolled maternal/infant dyads.

n = 132 maternal/infant pairs

38%

Results

the percentage of infants with a specific heart defect who experienced low oxygen levels after birth

n = 132 maternal/infant pairs

More results

Univariate and multivariate analyses showed no significant anatomic or physiologic fetal echocardiography predictors of neonatal hypoxia.

More results

Sensitivity analysis showed that an increasing Foramen ovale: Total septal length ratio and increasing atrial septal excursion ratio decreased the likelihood of combined outcome of hypoxia and BAS, but still did not provide useful discrimination to predict outcome.

Survival to initial hospital discharge occurred in 131/132(99%).

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Conclusion · 1 of 2

Our multicenter prospective study did not identify any sensitive prenatal predictors of neonatal hypoxia in infants prenatally diagnosed with TGA/IVS.

Conclusion · 2 of 2

High risk delivery planning for the possibility of neonatal hypoxia and urgent BAS is needed for all infants with prenatally diagnosed TGA/IVS.

Post

Fetal Anatomic and Physiologic Predictors of Neonatal Hypoxia in D-Transposition of the Great Arteries: A Prospective, Multi-Center Study by the Fetal Heart Society Research Collaborative.

Neonatal hypoxia occurred in 38% of infants with D-transposition of the great arteries.

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