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Objective To evaluate the antepartum foramen ovale (FO) and ratios of foramen ovale and aorta (FO/AO) by ROC curve predicate on postpartum atrial septal defect (ASD).Methods 958 fetuses was divided into 5 groups by gestational age, the FO and aortic (AO) diameter and FO/AO were measured by antepartum fetal echocardiography, follow up the postpartum echocardiography more than 12 months after birth.ANOVA was used to compare FO, AO, FO/AO with different gestational age.Regression equation estimate was used to compare the relationship of FO and AO with gestational age.Independent sample T test was used to compare FO and FO/AO with postpartum ASD and normal heart.ROC curve was used to assess the antepartum FO and FO/AO predicate on the cut-off value, sensitivity, specificity of postpartum ASD.Results There was significant differences in FOand AO among 5 groups (P=0.000), the FO and AO diameter increased with increasing gestational age.There was significant differences in FO, FO/AO between postpartum ASD and normal heart (P=0.000).The area under ROC curve was 0.991, 0.986, 0.991, 0.998, 1.000 during 18~22 weeks, 23~26 weeks, 27~30 weeks, 31~34 weeks, 35~40 weeks respectively.The cut-off value of antepartum FO predicate on postpartum ASD was 5.02mm, 5.15mm, 6.55mm, 8.55mm, 7.90mm respectively.The sensitivity was 100% in different gestational ages.The specificity was 98.2%, 90.5%, 97.3%,99.2%, 100% respectively.The area under ROC curve was 0.958, 0.937, 0.974, 0.967, 0.961.The cut-off value of antepartum FO/AO predicate on postpartum ASD was 1.28, 1.40, 1.32, 1.33, 1.22 respectively.The sensitivity was 100%, 83.3%, 100%, 100%, 100% respectively.The specificity was 83.0%, 78.4%, 92.9%, 92.2%, 94.1% respectively.Conclusion Antepartum FO and FO/AO have a high sensitivity and clinical value in predicating on postpartum ASD.