This study aimed to describe and compare neonatal retrieval medical interventions among newborns with a postnatal vs antenatal diagnosis of critical congenital heart disease (CHD).

The study design was a retrospective medical record review of infants aged ≤30 days admitted to The Royal Children’s Hospital, Melbourne, Australia, with CHD from 2016 to 2020. Electronic data were collected, including demographic data, presenting signs, retrieval events, and mortality. Participants were separated into two groups for analysis: those with a postnatal diagnosis and those with an antenatal diagnosis of CHD.

Of the 335 infants admitted with CHD, 30% had a postnatal diagnosis. Infants with a postnatal diagnosis had more resource-intensive retrievals requiring more respiratory support, supplemental oxygen, inhaled nitric oxide, and antibiotic administration. These infants also presented with higher numbers of respiratory and cardiovascular signs of illness at presentation. For infants with a postnatal diagnosis of critical CHD, the median age at symptom presentation and emergency retrieval was 26 and 91 hours, respectively. Four percent of infants died before 30 days of age.

Infants with a postnatal diagnosis of critical CHD present later, with more signs of illness, resulting in more resource-intensive emergency retrievals. A lower threshold for suspicion of CHD by referring paediatric clinicians in the newborn period may enable more timely transport of at-risk infants. This study has identified potential areas for future research aimed at expediting cardiac diagnosis at the time of illness presentation.