Abstract 10182: Aerobic Capacity Predicts Fetal Development and the Maternal Pregnancy Related Events in Adults with Congenital Heart Disease
Background: Whether maternal aerobic capacity (peak oxygen uptake; pVO2) can predict the maternal and fetal pregnancy-related events remains unknown in adults with congenital heart disease (ACHD).
Objectives: To evaluate whether maternal pVO2 has prognostic information on the maternal and fetal morbidity in ACHD.
Methods and Results: We reviewed pregnancy-related events in 32 ACHD patients (atrial/ventricular septal defect in 10, tetralogy in 8, and others in 14, New York Heart Association class I/II/III = 26/4/2) who had undergone exercise testing 3.0 ± 2.5 years before their pregnancy and pregnancy-related events were compared with 15 control pregnancies. In the ACHD, the pVO2 was 28.5 ± 7.1 (ml/kg/min) and heart failure, heart failure plus arrhythmia, arrhythmia and obstetric events were observed in 5, 3, 1, and 4 patients, respectively. The gestational week (37 ±4) was shorter and the birth weight was lower (2693 ± 534 g) than the controls (p < 0.05-0.01). Patients with cardiac and obstetric events had a lower pVO2 than those without the events (p < 0.01) and pVO2 correlated with the birth weight (r = 0.48, p < 0.01). Multivariate logistic model revealed that pVO2 independently predicted the cardiac events (OR; 0.83, 95% CI 0.71-0.97, p = 0.02) and patients with a pVO2 ≥ 24 experienced no cardiac events (sensitivity = 100%, specificity = 50%).
Conclusions: A lower pVO2 strongly predicts maternal pregnancy-related cardiac events and low neonatal birth weight. A pVO2 ≥ 24 (ml/kg/min) may be one of valuable criteria for safety pregnancy in ACHD patients.
- © 2011 by American Heart Association, Inc.