Pregnant Women With Uncorrected Congenital Heart Disease: Heart Failure and Mortality
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Pregnant Women With Uncorrected Congenital Heart Disease: Heart Failure and Mortality. / Sliwa, Karen; Baris, Lucia; Sinning, Christoph; Zengin-Sahm, Elvin; Gumbiene, Lina; Yaseen, Israa F; Youssef, Ghada; Johnson, Mark; Al-Farhan, Hasan; Lelonek, Malgorzata; Hall, Roger; Roos-Hesselink, Jolien.
in: JACC-HEART FAIL, Jahrgang 8, Nr. 2, 02.2020, S. 100-110.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Pregnant Women With Uncorrected Congenital Heart Disease: Heart Failure and Mortality
AU - Sliwa, Karen
AU - Baris, Lucia
AU - Sinning, Christoph
AU - Zengin-Sahm, Elvin
AU - Gumbiene, Lina
AU - Yaseen, Israa F
AU - Youssef, Ghada
AU - Johnson, Mark
AU - Al-Farhan, Hasan
AU - Lelonek, Malgorzata
AU - Hall, Roger
AU - Roos-Hesselink, Jolien
N1 - Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2020/2
Y1 - 2020/2
N2 - OBJECTIVES: The purpose of this work was to study maternal and fetal outcomes of women with uncorrected congenital heart disease (CHD).BACKGROUND: Globally, CHD is an important cause of maternal morbidity and mortality in women reaching reproductive stage. Data are lacking from larger cohorts of women with uncorrected CHD.METHODS: The 10-year data from the European Society of Cardiology EORP ROPAC (EURObservational Research Programme Registry of Pregnancy and Cardiac disease) registry of women with uncorrected CHD were analyzed.RESULTS: Of 5,739 pregnancies in 53 countries, 3,295 women had CHD, 1,059 of which were uncorrected cases. Of these, 41.4% were from emerging countries. There were marked differences between the cardiac defects in uncorrected cases versus those in corrected CHD cases with primary shunt lesions (44.7% vs. 32.4%, respectively), valvular abnormalities (33.5% vs. 12.6%, respectively), and Tetralogy of Fallot and pulmonary atresia (0.8% vs. 20.3%, respectively; p < 0.001). In patients with uncorrected CHD, 6.8% were in modified World Health Organization risk class IV, approximately 10% had pulmonary hypertension (PH), and 3% were cyanotic prior to pregnancy. Maternal mortality and heart failure (HF) in the women with uncorrected CHD were 0.7% and 8.7%, respectively. Eisenmenger syndrome was associated with a very high risk of cardiac events (65.5%), maternal mortality (10.3%), and HF (48.3%). Coming from an emerging country was associated with higher pre-pregnancy signs of HF, PH, and cyanosis (p < 0.001) and worse maternal and fetal outcomes, with a 3-fold higher rate of hospital admissions for cardiac events and intrauterine growth retardation (p < 0.001).CONCLUSIONS: Marked differences between cardiac conditions in pregnant women with uncorrected CHD and those in corrected CHD were found, with a markedly worse outcome, particularly in women with Eisenmenger syndrome and from emerging countries.
AB - OBJECTIVES: The purpose of this work was to study maternal and fetal outcomes of women with uncorrected congenital heart disease (CHD).BACKGROUND: Globally, CHD is an important cause of maternal morbidity and mortality in women reaching reproductive stage. Data are lacking from larger cohorts of women with uncorrected CHD.METHODS: The 10-year data from the European Society of Cardiology EORP ROPAC (EURObservational Research Programme Registry of Pregnancy and Cardiac disease) registry of women with uncorrected CHD were analyzed.RESULTS: Of 5,739 pregnancies in 53 countries, 3,295 women had CHD, 1,059 of which were uncorrected cases. Of these, 41.4% were from emerging countries. There were marked differences between the cardiac defects in uncorrected cases versus those in corrected CHD cases with primary shunt lesions (44.7% vs. 32.4%, respectively), valvular abnormalities (33.5% vs. 12.6%, respectively), and Tetralogy of Fallot and pulmonary atresia (0.8% vs. 20.3%, respectively; p < 0.001). In patients with uncorrected CHD, 6.8% were in modified World Health Organization risk class IV, approximately 10% had pulmonary hypertension (PH), and 3% were cyanotic prior to pregnancy. Maternal mortality and heart failure (HF) in the women with uncorrected CHD were 0.7% and 8.7%, respectively. Eisenmenger syndrome was associated with a very high risk of cardiac events (65.5%), maternal mortality (10.3%), and HF (48.3%). Coming from an emerging country was associated with higher pre-pregnancy signs of HF, PH, and cyanosis (p < 0.001) and worse maternal and fetal outcomes, with a 3-fold higher rate of hospital admissions for cardiac events and intrauterine growth retardation (p < 0.001).CONCLUSIONS: Marked differences between cardiac conditions in pregnant women with uncorrected CHD and those in corrected CHD were found, with a markedly worse outcome, particularly in women with Eisenmenger syndrome and from emerging countries.
KW - Adult
KW - Female
KW - Follow-Up Studies
KW - Global Health
KW - Heart Defects, Congenital/complications
KW - Heart Failure/epidemiology
KW - Humans
KW - Incidence
KW - Maternal Mortality/trends
KW - Pregnancy
KW - Pregnancy Complications, Cardiovascular
KW - Prospective Studies
KW - Registries
KW - Time Factors
U2 - 10.1016/j.jchf.2019.09.001
DO - 10.1016/j.jchf.2019.09.001
M3 - SCORING: Journal article
C2 - 31511192
VL - 8
SP - 100
EP - 110
JO - JACC-HEART FAIL
JF - JACC-HEART FAIL
SN - 2213-1779
IS - 2
ER -
