Abstract 4681: Rising Numbers of Pregnancies and Offspring in Women with Congenital Heart Disease: A Population-Based Study
The prevalence of adults with congenital heart disease (CHD) is increasing. There are limited population data on the prevalence and outcomes of pregnancy on the changing adult CHD population. Data was obtained from previously validated physician claims and hospital discharge databases of Quebec from 1992–2004. ICD-9 diagnostic and procedure codes were used to identify all women aged 18 – 45 years with CHD and to define pregnancy, abortion (spontaneous and therapeutic) and delivery (vaginal and cesarean-section). The number of reproductive events per year was calculated. The database identified 36,894 women with CHD between 1992 and 2004. There were 6,264 women between the ages of 18 – 45 years who became pregnant during this time for a total of 10,091 pregnancies. Since 1992, the number of pregnancies has steadily increased from 696 to 872 in 2004. Concurrently, the relative proportion of deliveries has also increased over this period (0.61 in 1992 vs. 0.78 in 2004) along with a decrease in the relative proportion of abortions (0.39 in 1992 vs. 0.22 in 2004) in this cohort (figure 1⇓). Twelve percent (n=767) of pregnant women had a severe form of CHD (tetralogy of Fallot, truncus arteriosus, transposition complex, endocardial cushion defect and univentricular heart). The rising numbers of pregnancies and deliveries and the decreasing number of abortions amongst women with CHD may influence the birth prevalence of CHD in offspring. The increasing need for specialized cardiology and obstetrical care in this population will have important implications for the health care system.