A Wacker-Gussmann1, M Thriemer, M Yigitbasi, F Berger, N Nagdyman. 1. Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. annette.wacker@med.uni-tuebingen.de
Abstract
BACKGROUND: Pregnancy in women with congenital cardiac disease is more frequent due to an increased lifespan and improved health situations. However, the long-term outcomes in these women are not known. METHODS: We analysed 267 consecutive pregnant women with congenital heart defects who were seen at the German Heart Centre Berlin. This retrospective study included analysis of long-term follow-up data after pregnancy and standard maternal cardiac, obstetric and neonatal outcomes. The long-term data (n = 103) were acquired with a self-assessment questionnaire from each patient. The main primary outcomes of the study included functional class, health, work capability and physical activity. RESULTS: The median age of the patients at delivery was 27 years (range 17-43 years). The median follow-up of all patients was 11 years (range 1-49 years). Twenty-four percent exhibited complex cardiac defects. Primary long-term outcomes included good health in 61 % of the patients. Approximately 68 % worked, and 76 % engaged in physical activity. Thirty-three percent of the women who answered the questionnaire demonstrated a decrease in functional class during pregnancy, but more than two-thirds of these patients subsequently improved. Secondary short-term outcomes included a 4 % miscarriage rate and a 4 % induced abortion rate. The maternal cardiac data revealed that 30 % of the patients lost at least one functional class during pregnancy. Onset arrhythmias were observed in 12 % of the patients. The most prevalent neonatal complication was premature birth, which was present in 12 % of the neonates. CONCLUSION: Two-thirds of the patients tolerated pregnancy without cardiovascular complications. Most patients displayed good long-term health, work capability and physical activity outcomes. Further prospective controlled studies are necessary to confirm these results and safely advise pregnant women.
BACKGROUND: Pregnancy in women with congenital cardiac disease is more frequent due to an increased lifespan and improved health situations. However, the long-term outcomes in these women are not known. METHODS: We analysed 267 consecutive pregnant women with congenital heart defects who were seen at the German Heart Centre Berlin. This retrospective study included analysis of long-term follow-up data after pregnancy and standard maternal cardiac, obstetric and neonatal outcomes. The long-term data (n = 103) were acquired with a self-assessment questionnaire from each patient. The main primary outcomes of the study included functional class, health, work capability and physical activity. RESULTS: The median age of the patients at delivery was 27 years (range 17-43 years). The median follow-up of all patients was 11 years (range 1-49 years). Twenty-four percent exhibited complex cardiac defects. Primary long-term outcomes included good health in 61 % of the patients. Approximately 68 % worked, and 76 % engaged in physical activity. Thirty-three percent of the women who answered the questionnaire demonstrated a decrease in functional class during pregnancy, but more than two-thirds of these patients subsequently improved. Secondary short-term outcomes included a 4 % miscarriage rate and a 4 % induced abortion rate. The maternal cardiac data revealed that 30 % of the patients lost at least one functional class during pregnancy. Onset arrhythmias were observed in 12 % of the patients. The most prevalent neonatal complication was premature birth, which was present in 12 % of the neonates. CONCLUSION: Two-thirds of the patients tolerated pregnancy without cardiovascular complications. Most patients displayed good long-term health, work capability and physical activity outcomes. Further prospective controlled studies are necessary to confirm these results and safely advise pregnant women.
Authors: Helmut Baumgartner; Philipp Bonhoeffer; Natasja M S De Groot; Fokko de Haan; John Erik Deanfield; Nazzareno Galie; Michael A Gatzoulis; Christa Gohlke-Baerwolf; Harald Kaemmerer; Philip Kilner; Folkert Meijboom; Barbara J M Mulder; Erwin Oechslin; Jose M Oliver; Alain Serraf; Andras Szatmari; Erik Thaulow; Pascal R Vouhe; Edmond Walma Journal: Eur Heart J Date: 2010-08-27 Impact factor: 29.983
Authors: Emily Gelson; Ruth Curry; Michael A Gatzoulis; Lorna Swan; Martin Lupton; Philip Steer; Mark Johnson Journal: Obstet Gynecol Date: 2011-04 Impact factor: 7.661
Authors: Annette Wacker; Harald Kaemmerer; Regina Hollweck; Michael Hauser; Marc Andre Deutsch; Silke Brodherr-Heberlein; Andreas Eicken; John Hess Journal: Am J Cardiol Date: 2005-03-15 Impact factor: 2.778
Authors: Julia Lemmer; Grit Heise; Axel Rentzsch; Petra Boettler; Titus Kuehne; Karl Otto Dubowy; Brigitte Peters; Bjoern Lemmer; Alfred Hager; Brigitte Stiller Journal: Clin Res Cardiol Date: 2010-10-28 Impact factor: 5.460
Authors: Samuel C Siu; Jack M Colman; Sheryll Sorensen; Jeffrey F Smallhorn; Dan Farine; Kofi S Amankwah; John C Spears; Mathew Sermer Journal: Circulation Date: 2002-05-07 Impact factor: 29.690
Authors: Vera Regitz-Zagrosek; Carina Blomstrom Lundqvist; Claudio Borghi; Renata Cifkova; Rafael Ferreira; Jean-Michel Foidart; J Simon R Gibbs; Christa Gohlke-Baerwolf; Bulent Gorenek; Bernard Iung; Mike Kirby; Angela H E M Maas; Joao Morais; Petros Nihoyannopoulos; Petronella G Pieper; Patrizia Presbitero; Jolien W Roos-Hesselink; Maria Schaufelberger; Ute Seeland; Lucia Torracca Journal: Eur Heart J Date: 2011-08-26 Impact factor: 29.983
Authors: Willem Drenthen; Petronella G Pieper; Jolien W Roos-Hesselink; Willem A van Lottum; Adriaan A Voors; Barbara J M Mulder; Arie P J van Dijk; Hubert W Vliegen; Sing C Yap; Philip Moons; Tjark Ebels; Dirk J van Veldhuisen Journal: J Am Coll Cardiol Date: 2007-06-04 Impact factor: 24.094