Neonatal Outcomes in Transposition of the Great Arteries by Mode and Timing of Delivery

Abstract Objective: We aimed to assess neonatal outcomes by mode of delivery and to evaluate the value of achieving daytime delivery among neonates undergoing a planned induction of labor (IOL). Method: This was a retrospective study of pregnancies with prenatally diagnosed d-TGA with an IVS receiving care at a single tertiary care referral center from 2020-23. Inclusion required prenatal diagnosis of d-TGA with an IVS and surgical care at the referral center. The primary outcome was a composite of neonatal outcomes. Pearson chi-square or Fisher’s exact test were performed as appropriate. Results: We identified 90 cases of prenatally diagnosed d-TGA, of which 68 (76%) underwent timed IOL and 46 (68%) achieved vaginal delivery. The primary outcome occurred in 16 neonates (89%) who delivered by cesarean and 47 neonates (78%) who underwent a planned timed IOL (p=0.26). Among individuals undergoing IOL, the primary outcome occurred in 29 neonates (73%) who delivered during the daytime and 18 (90%) who delivered after-hours (p=0.19). Conclusion: We found that in cases of prenatally diagnosed d-TGA with an IVS , IOL is feasible. Neonates with d-TGA with an IVS had similar surgical outcomes when induced and delivered at this single tertiary care center, regardless of delivery time.

Publication History

Received: 12 February 2025

Accepted after revision: 30 July 2025

Accepted Manuscript online:
30 July 2025