Maternal Comorbidity Higher for Women With Congenital Heart Defects
TUESDAY, April 30, 2019 -- Pregnant women with congenital heart defects (CHDs) are more likely to have comorbidities and experience adverse events during delivery, according to a study published in the May 7 issue of the Journal of the American College of Cardiology.
Using multivariable logistic regression, Lauren E. Schlichting, Ph.D., of the Hassenfeld Child Health Innovation Institute at Brown University in Providence, Rhode Island, and colleagues compared comorbidities and adverse delivery events for 22,881,691 deliveries identified in the 2008 to 2013 National Inpatient Sample. In addition, the authors examined the association between CHD severity and presence of pulmonary hypertension (PH).
There were 17,729 deliveries to women with CHDs recorded (77.5 of 100,000 deliveries). The researchers found that the odds of comorbidities, including PH, congestive heart failure, and coronary artery disease, were greater for women with CHDs, and greater odds of adverse events such as heart failure, arrhythmias, thromboembolic events, preeclampsia, and placenta previa were also noted. It was more common for women with CHDs to experience cesarean section, induction, and operative vaginal delivery; however, it was less common for them to experience fetal distress. In regards to adverse events, PH was associated with heart failure, hypertension in pregnancy, preeclampsia, and preterm delivery, but CHD severity did not appear to affect most adverse events.
"As a result, women with CHDs, especially severe forms, have complex health care needs and increased health care utilization, as evidenced by their longer hospital stays and higher delivery charges," the authors write.
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Posted: April 2019