There are conflicting data on how delivery location impacts outcomes in neonates with ductal-dependent heart disease. Our goal was to evaluate the impact of delivery location on hospital length of stay and survival in infants with prenatally diagnosed hypoplastic left heart syndrome (HLHS) after stage 1 palliation (S1P). A multicenter cohort study was performed utilizing the National Pediatric Cardiology Quality Improvement Collaborative dataset for infants with prenatally diagnosed HLHS who underwent S1P from August 2016 to December 2018. Univariate comparisons of demographics, clinical, and outcome data were made and multivariable logistic regression was performed between groups stratified by distance from surgical center. A total of 790 patients from 33 centers were analyzed: 85% were born < 5 miles from the surgical center with 72% of those (486/673) born at the surgical center. Infants born < 5 miles from the surgical center were significantly (p < 0.05) more likely to be male, white, full term, have no non-cardiac anomaly, and have commercial health insurance; they were significantly more likely to breastfeed pre-operatively, and less likely to have pre-operative cardiac catheterizations, pre-operative mechanical ventilation, or delayed surgery. There was no significant difference between groups in hospital length of stay, 30-day survival, or survival to hospital discharge. In this multicenter dataset, hospital length of stay and survival after S1P did not differ based on distance from birth location to surgical center. However, neonates born < 5 miles from the surgical center had lower rates of potentially modifiable pre-operative risk factors including mechanical ventilation and delays to surgery.

关于分娩地点如何影响患有导管依赖性心脏病的新生儿的结果，存在相互矛盾的数据。我们的目标是评估分娩地点对产前诊断为左心发育不全综合征 (HLHS) 的婴儿在 1 期姑息治疗 (S1P) 后住院时间和存活率的影响。利用国家儿科心脏病学质量改进协作数据集对 2016 年 8 月至 2018 年 12 月接受 S1P 的产前诊断为 HLHS 婴儿进行了一项多中心队列研究。对人口统计学、临床和结果数据进行了单变量比较，并在之间进行了多变量逻辑回归按距手术中心的距离分层的组。共分析了来自 33 个中心的 790 名患者：85% 出生于 < 距外科中心 5 英里，其中 72% (486/673) 出生在外科中心。距手术中心<5英里出生的婴儿显着（p  < 0.05) 更有可能是男性、白人、足月、没有非心脏异常并且有商业健康保险；他们明显更有可能在术前进行母乳喂养，并且不太可能进行术前心导管插入术、术前机械通气或延迟手术。在住院时间、30 天生存期或出院生存率方面，各组之间没有显着差异。在这个多中心数据集中，S1P 后的住院时间和生存率没有因出生地到手术中心的距离而异。然而，出生距离手术中心<5英里的新生儿具有较低的潜在可改变的术前风险因素，包括机械通气和手术延误。