Abstract 18062: Neonatal Outcomes and Maternal Morbidity Associated With Pregnancy in Women with Congenital Heart Disease
Background: Women with congenital heart disease (WCHD) who are considering pregnancy need counseling regarding maternal and offspring risk. Previous studies have not focused on neonatal outcomes and have mostly described lower risk patients.
Methods and Results: We enrolled 113 WCHD (mean age 32 ± 5 years, 51% with NYHA functional class >1, 28% with World Health Organization (WHO) risk class > 2, 81% with moderate or higher CHD complexity) in our study and reviewed the medical record for their baseline cardiac status as well as their post-natal outcomes. We compared our cohort to a demographically similar cohort of patients (n = 147) without CHD. Neonatal outcomes included prematurity (< 37 weeks gestation), admission to the NICU, low birth weight (< 2.5 kg), and neonatal death, while maternal outcomes were arrhythmias, heart failure, stroke, and death. Significant predictors of neonatal complications included history of cyanotic CHD (OR 3.1, CI 1.0-9.7, p = 0.04), need for cardiac medications (OR 3.2, CI 1.0-10.2, p = 0.04), and WHO class > 2 (OR 3.5, CI 1.1-11.1, p = 0.03). WHO class (OR 4.0, CI 1.1-15.2, p = 0.03) independently predicated maternal complications. Compared to controls, neonates born to WCHD were more likely to be premature (29 vs. 7%, p < 0.01), low birth weight (27 vs. 3%, p < 0.01), and admitted to the NICU (19 vs. 8%, p = 0.01).
Conclusions: Preconception counseling for women with CHD should include assessment of neonatal risk in addition to maternal risk. While women with more complex CHD can complete pregnancy successfully, both mother and offspring must endure higher odds of complications.
Author Disclosures: C. Hebson: None. D. Lin: None. T. Ayer: None. J. Vlachy: None. M. Badell: None. M. Platner: None. A. Katabarwa: None. J. Shinnick: None. A. Sahu: None. W. Book: None.
- © 2014 by American Heart Association, Inc.