Rakefet Sidlik1, Eyal Sheiner, Amalia Levy, Arnon Wiznitzer. 1. Department of Obstetrics & Gynecology, Faculty of Health Services, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Abstract
OBJECTIVE: The primary objective of this study was to characterize the delivery outcome of parturients with congenital heart defects (CHD), from maternal and from neonatal perspectives. STUDY DESIGN: A retrospective population-based study was conducted, covering a 13-year period (1989-2002) with an aggregate of 151,487 deliveries of all women with and without CHD. Maternal demographics, obstetrical and medical history, delivery outcome, and neonatal outcome were drawn from a computerized perinatal database. RESULTS: Sixty-seven women with CHD had 156 deliveries. The severity of CHD, based on the New York Heart Association (NYHA) classification, was I or II in 99.1% of the deliveries. CHD patients had significantly higher rates of labor induction and neonatal malformations. Maternal CHD was discovered as an independent risk factor associated with neonatal malformations (OR 2.10, 95% CI 1.18-3.72). No significant differences were noted between women with CHD and the controls regarding maternal morbidities and Apgar scores. CONCLUSIONS: The labor outcome of CHD patients with NYHA classification I and II resembles that of non-CHD women in a tertiary center setting. Neonates of CHD mothers have higher rates of congenital malformations even among asymptomatic or mildly symptomatic mothers. A careful sonographic follow-up is warranted among all pregnancies of CHD patients.
OBJECTIVE: The primary objective of this study was to characterize the delivery outcome of parturients with congenital heart defects (CHD), from maternal and from neonatal perspectives. STUDY DESIGN: A retrospective population-based study was conducted, covering a 13-year period (1989-2002) with an aggregate of 151,487 deliveries of all women with and without CHD. Maternal demographics, obstetrical and medical history, delivery outcome, and neonatal outcome were drawn from a computerized perinatal database. RESULTS: Sixty-seven women with CHD had 156 deliveries. The severity of CHD, based on the New York Heart Association (NYHA) classification, was I or II in 99.1% of the deliveries. CHD patients had significantly higher rates of labor induction and neonatal malformations. Maternal CHD was discovered as an independent risk factor associated with neonatal malformations (OR 2.10, 95% CI 1.18-3.72). No significant differences were noted between women with CHD and the controls regarding maternal morbidities and Apgar scores. CONCLUSIONS: The labor outcome of CHD patients with NYHA classification I and II resembles that of non-CHD women in a tertiary center setting. Neonates of CHD mothers have higher rates of congenital malformations even among asymptomatic or mildly symptomatic mothers. A careful sonographic follow-up is warranted among all pregnancies of CHD patients.
Authors: Anne Marie Kirkegaard; Maria Breckling; Dorte Guldbrand Nielsen; Janne S Tolstrup; Søren Paaske Johnsen; Annette Kjær Ersbøll; Stine Kloster Journal: BMC Pregnancy Childbirth Date: 2021-12-07 Impact factor: 3.007