Prospective Multicenter Study of Pregnancy Outcomes in Women With Heart Disease Academic Article uri icon

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abstract

  • BACKGROUND: The maternal and neonatal risks associated with pregnancy in women with heart disease receiving comprehensive prenatal care have not been well defined. METHODS AND RESULTS: We prospectively enrolled 562 consecutive pregnant women with heart disease and determined the outcomes of 599 pregnancies not ending in miscarriage. Pulmonary edema, arrhythmia, stroke, or cardiac death complicated 13% of pregnancies. Prior cardiac events or arrhythmia, poor functional class or cyanosis, left heart obstruction, and left ventricular systolic dysfunction independently predicted maternal cardiac complications; the cardiac event rate can be predicted using a risk index incorporating these predictors. Neonatal complications (20% of pregnancies) were associated with poor functional class or cyanosis, left heart obstruction, anticoagulation, smoking, and multiple gestations. CONCLUSIONS: Pregnancy in women with heart disease is associated with significant cardiac and neonatal complications, despite state-of-the-art obstetric and cardiac care. Maternal cardiac risk can be predicted with the use of a risk index.

authors

  • Siu, Samuel C
  • Sermer, Mathew
  • Colman, Jack M
  • Alvarez, A Nanette
  • Mercier, Lise-Andree
  • Morton, Brian C
  • Kells, Catherine M
  • Bergin, M Lynn
  • Kiess, Marla C
  • Marcotte, Francois
  • Taylor, Dylan A
  • Gordon, Elaine Paula
  • Spears, John C
  • Tam, James W
  • Amankwah, Kofi S
  • Smallhorn, Jeffrey F
  • Farine, Dan
  • Sorensen, Sheryll

publication date

  • July 31, 2001

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