Effect of maternal congenital heart defects on labor and delivery outcome: a population-based study

J Matern Fetal Neonatal Med. 2007 Mar;20(3):211-6. doi: 10.1080/14767050600923980.

Abstract

Objective: The primary objective of this study was to characterize the delivery outcome of parturients with congenital heart defects (CHD), from maternal and from neonatal perspectives.

Study design: A retrospective population-based study was conducted, covering a 13-year period (1989-2002) with an aggregate of 151,487 deliveries of all women with and without CHD. Maternal demographics, obstetrical and medical history, delivery outcome, and neonatal outcome were drawn from a computerized perinatal database.

Results: Sixty-seven women with CHD had 156 deliveries. The severity of CHD, based on the New York Heart Association (NYHA) classification, was I or II in 99.1% of the deliveries. CHD patients had significantly higher rates of labor induction and neonatal malformations. Maternal CHD was discovered as an independent risk factor associated with neonatal malformations (OR 2.10, 95% CI 1.18-3.72). No significant differences were noted between women with CHD and the controls regarding maternal morbidities and Apgar scores.

Conclusions: The labor outcome of CHD patients with NYHA classification I and II resembles that of non-CHD women in a tertiary center setting. Neonates of CHD mothers have higher rates of congenital malformations even among asymptomatic or mildly symptomatic mothers. A careful sonographic follow-up is warranted among all pregnancies of CHD patients.

MeSH terms

  • Adult
  • Female
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / epidemiology
  • Humans
  • Multivariate Analysis
  • Obstetric Labor Complications / epidemiology*
  • Parity
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology*
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies