Adverse fetal/neonatal and obstetric outcomes in pregnancies with both maternal and fetal heart disease

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2024年7月23日

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Beatriz A. Fernandez-Campos,
Jasmine Grewal,
Marla Kiess,
Samuel C. Siu,
Birgit Pfaller,
Mathew Sermer,
Jennifer Mason,
Candice K. Silversides,
Kim Haberer

摘要

Objective

To investigate fetal/neonatal and obstetric events in pregnancies with both maternal and fetal heart disease.

Study design

From the CARPREG database, singleton pregnancies (>24 weeks) in patients with structural heart disease that underwent fetal/neonatal echocardiograms were selected and separated in two groups: maternal heart disease only (M-HD) and maternal and fetal heart disease (MF-HD). Differences in adverse fetal/neonatal (death, preterm birth, and small for gestational age) and obstetric (preeclampsia/eclampsia) outcomes between groups were analyzed.

Results

From 1011 pregnancies, 93 had MF-HD. Fetal/neonatal events (38.7% vs 25.3%, p = 0.006) and spontaneous preterm birth (10.8% vs 4.9%, p = 0.021) were more frequent in MF-HD compared to M-HD, with no difference in obstetric events. MF-HD remained as a significant predictor of fetal/neonatal events after adjustment (OR:1.883; 95% CI:1.182–3.000; p = 0.008).

Conclusions

Pregnancies with MF-HD are at risk of adverse fetal/neonatal events and spontaneous preterm birth. Larger studies are needed to determine their association with preeclampsia.