An investigation of the optimal inter-pregnancy interval following pregnancy with a fetus with congenital heart disease

Abstract

Introduction: Congenital heart defects (CHD) are one of the most commonly diagnosed congenital malformations in fetuses and newborns. The aim of the study was to determine whether inter-pregnancy interval (IPI), maternal age or number of pregnancies had any influence on the recurrence of congenital heart disease in subsequent pregnancies. Material and methods: We found in our database 144 women with subsequent pregnancies after CHD in a previous pregnancy. Each woman was selected according to the eligibility and exclusion criteria. Medical history as well as obstetrics history were recorded. Comparisons of groups with and without a recurrence of CHD were performed. We calculated hazard ratios for recurrence of CHD. We also performed analysis of the impact of confounding variables: maternal age and parity. Missing data were excluded from the analysis. Smoking habits as well as socio-demographic characteristics were not evaluated in this study. Results: A higher risk of recurrence of CHD correlated with a shorter IPI, with a median of 11 months compared with 24 months for the group of healthy fetuses in subsequent pregnancy. The results were statistically significant. Parity was proven to be an important confounder of the study. Multivariable analysis including parity and maternal age did not affect the confidence intervals of hazard ratios for IPI. Conclusions: The optimal IPI to reduce the risk of recurrence of CHD is 24 months. Shorter intervals are related to a higher risk of recurrence of CHD in the next pregnancy and are independent on the age of the woman and parity.

Increased maternal phenylalanine concentration may influence not only fetal heart structural development but also cardiovascular function and pulmonary tissue development in humans – a case report

“…Prediction of PPHT is not an easy task and requires adequate experience and at least a few fetal echocardiography examinations (especially in the third trimester of pregnancy). In our case that was profoundly difficult because prenatal diagnosis was complex: the disproportion and dilation of MPA and right side of the fetal heart was probably caused by the abnormal fetal pulmonary tissue development and concomitant with features of evolving fetal hypoplastic left heart syndrome [3,7]. The limitation of the case report is the lack of an autopsy.…”

“…The case report involves was the second pregnancy of a 23-year-old woman. She had an early miscarriage less than 2 years before the second conception [3]. The patient was diagnosed in her childhood with phenylketonuria and did not stick to the recommended diet.…”

Prenatal diagnosis of right-sided congenital diaphragmatic hernia

“…The presented case involved a high-risk pregnancy that commenced 3 months after a prior miscarriage. Research by Strzelecka et al indicates that, in instances of poor outcome of previous pregnancy (miscarriage or congenital heart defects in the fetus), maintaining an interval of at least 24 months between pregnancies may increase the probability of normal outcome in a subsequent pregnancy [1].…”

Neonatal manifestation of 22q11.2 deletion syndrome – four case reports and a mini-literature review

“…As regards the siblings in question, the interval between pregnancies was six months. The International Prenatal Cardiology Collaboration group found a higher risk of recurrence of congenital heart disease (CHD) correlated with a shorter inter-pregnancy interval, with a median of 11 months compared to 24 months for the group of healthy foetals in subsequent pregnancy with CHD [5]. The siblings with diagnosed 22q11.2 deletion were subject to ultrasound examination which revealed thymus hypoplasia, while the ultrasound imaging of the brain and the abdominal cavity did not show any anatomic abnormalities.…”