Fetal Anatomic and Physiologic Predictors of Neonatal Hypoxia in D-Transposition of the Great Arteries: A…

Cohort studyJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography· Jul 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 studyPrognosisQ1IF 3.7

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 … Fetal Heart Society Research Collaborative

Journal of the American Society of Echocardiography · Jul 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

38%

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 balloon atrial septostomy, 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 balloon atrial septostomy is needed for all infants with prenatally diagnosed TGA/IVS.

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.

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.

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