Cardiac Complications during Pregnancy Related to Parity in Women with Congenital Heart Disease

Furenäs, Eva; Eriksson, Peter; Wennerholm, Ulla‐Britt; Dellborg, Mikael

doi:10.1159/000508649

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…The samples of this research were taken from medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Based on a previous study by Furenäs, et al, an increase in the number of parities occurred along with an increase in the proportion of cardiac complications. 12 Another previous study by Parikh, et al, suggested that the association between parity and cardiovascular disease formed a pattern resembling the letter J, with the multiparity group as the lowest risk point. 13 The The distribution of pregnancies with cardiac disease based on maternal outcomes…”

Section: Methodsmentioning

confidence: 92%

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

Gayatri.

Lestari²,

Martadiansyah

et al. 2021

Bioscmed

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Background: Impaired maternal and uteroplacental perfusion can occur in pregnancy with cardiac disease leading to maternal and perinatal mortality and morbidity due to increased cardiac load and ventricular dysfunction. This research aims to determine maternal and perinatal outcomes of pregnancies with cardiac disease. Method: This research was a descriptive observational study conducted by a total sampling method and a cross-sectional design. This research used medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Mohammad Hoesin Palembang in January 2018-December 2020 as study samples. Result: Among 68 pregnancies with cardiac disease, there were 4 cases (0.87%) found in 2018, 37 cases (2.47%) found in 2019, and 27 cases (1.48%) found in 2020. The highest distribution of pregnancies with cardiac disease was found at 64.7% in the range of 20-35 years old age group; 57.4% in the multiparity group; 38.2% in the range of ≥34 – <37 weeks gestational age group; 86.8% in the high school educational level group; 66.2% in the high-risk cardiac functional status group; 54.4% in the peripartum cardiomyopathy group; and 36.8% with preeclampsia/eclampsia as a comorbid. In this study, maternal outcomes found were maternal mortality at 11.8%; cardiac failure at 70.6%; arrhythmia at 1.5%; and stroke at 1.5%, while perinatal outcomes found were prematurity at 60.3%; low birth weight at 64.4%; IUGR at 37.0%; IUFD at 1.4%; stillbirth at 6.8%; neonatal death at 9.6%; and perinatal asphyxia at 42.5%. Conclusion: The prevalence rate of pregnancies with cardiac disease in RSUP Dr. Mohammad Hoesin Palembang was 0.87% in 2018, 2.47% in 2019, and 1.48% in 2020. The most common maternal outcome in this study was cardiac failure, with most in the peripartum cardiomyopathy group, while the most common perinatal outcome was low birth weight, with most in the hypertensive heart disease group.

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Section: Methodsmentioning

confidence: 92%

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

Gayatri.

Lestari²,

Martadiansyah

et al. 2021

Bioscmed

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“…Previous studies have shown that parity per se is not a factor regarding risk of cardiac complications during pregnancy 53 , 54 ; however, the effect of parity on long‐term cardiovascular health has not been addressed. We did not have statistical power to test if completing more pregnancies was more detrimental as compared with completing only 1 pregnancy regarding long‐term cardiovascular health.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register‐Based Cohort Study Between 1993 and 2016

Kloster

Tolstrup

Nielsen

et al. 2022

JAHA

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Background Little is known about the impact of pregnancy on long‐term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long‐term cardiovascular morbidity. Methods and Results We studied a cohort of 1262 individuals with CHD giving birth (live or still) from 1993 to 2015 using Danish nationwide registers. We randomly sampled a comparison cohort matched on age of women with CHD who had not given birth at the time. We balanced the 2 cohorts on baseline demographic (eg, education) and clinical variables (eg, CHD severity) using inverse probability of treatment weighting. Individuals were followed for critical (eg, heart failure), other cardiovascular morbidity (eg, arrhythmia), and cardiac surgery/interventions after pregnancy. Individuals were followed for median 6.0 years (interquartile range 3.2–9.2). Among individuals giving birth the incidence rate per 1000 person‐years was 1.6, 10.0, and 6.0 for critical and other cardiovascular morbidity and cardiac surgery, respectively. There was no overall difference in risk of neither critical and other cardiovascular morbidity nor cardiac surgery among individuals who gave birth and individuals who did not; adjusted hazard ratios (aHR) were 0.74 (95% CI, 0.37–1.48), 0.88 (95% CI, 0.65–1.19), and 0.78 (95% C,I 0.54–1.12), respectively. However, individuals with obstetric complications had a higher long‐term risk of other cardiovascular morbidity (aHR, 1.85; 95% CI, 1.07–3.20). Conclusions Giving birth seemed not to be associated with a higher risk of long‐term cardiovascular morbidity among women with CHD. However, individuals having obstetric complications had a higher risk of other cardiovascular morbidity in the long term.

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“…This study indicates that women with more complex heart disease (mWHO classes III or IV) tend to have neonates affected by FGR, give birth prematurely and deliver by cesarean section more often than women with less complex heart disease. Previously, obstetric and neonatal complications have been described in northern and western Sweden but FGR have not been described in the Swedish pregnant ACHD population before [12,13]. FGR is an interesting outcome due to the association between reduced cardiac function and placental insufficiency [14,15].…”

Section: Discussionmentioning

confidence: 99%

Increased cesarean section rate and premature birth according to modified WHO maternal cardiovascular risk in pregnant women with congenital heart disease

Wedlund,

von Wowern,

Hlebowicz

2023

PLoS ONE

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Background During pregnancy and delivery, hemodynamics are altered and complex congenital heart disease has been associated with adverse maternal and neonatal outcomes. We sought to investigate pregnancy outcome and complications in relation to complexity of heart condition. Materials and methods We studied women with ACHD discussed at multidisciplinary conferences at Lund University Hospital March 2009-May 2021. We studied 149 pregnancies in 101 women. We scored each woman retrospectively according to the modified World Health Organization (mWHO) risk classification and included patients in risk class I (n = 36, 24.1%), II (n = 43, 28.9%), II-III (n = 43, 28.9%), III (n = 24, 16.1%) and IV (n = 3, 2.0%). Results Women with mWHO class ≥III underwent cesarean section more often than women in less complex mWHO classes, (OR, 5.1; 95% CI, 2.0–12.5; p<0.001). The odds of premature delivery were significantly higher among pregnant women with mWHO class ≥III (OR, 6.7; 95% CI, 2.6–17.4; p<0.001). We found no difference in incidence of preeclampsia, gestational hypertension, gestational diabetes, hemorrhage >1000 ml or cardiac defect in the neonate depending on WHO-class. Women in mWHO classes III-IV had a higher rate of fetal growth restriction (FGR) compared to women in mWHO classes I, II, II-III (p<0.007). Conclusions Our findings indicate that women with more complex heart disease (mWHO classes III or IV) tend to have a higher rate of cesarean section, premature birth and FGR.

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Cardiac Complications during Pregnancy Related to Parity in Women with Congenital Heart Disease

Cited by 9 publications

References 17 publications

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

Long‐Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register‐Based Cohort Study Between 1993 and 2016

Increased cesarean section rate and premature birth according to modified WHO maternal cardiovascular risk in pregnant women with congenital heart disease

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