J Korean Med Sci.  2008 Oct;23(5):808-813. 10.3346/jkms.2008.23.5.808.

Outcomes of Pregnancy in Women with Congenital Heart Disease: A Single Center Experience in Korea

• Song YB
• Park SW
• Kim JH
• Shin DH
• Cho SW
• Choi JO
• Lee SC
• Moon JR
• Huh J
• Kang IS
• Lee HJ

• KMID: 1783065
• DOI: http://doi.org/10.3346/jkms.2008.23.5.808

Abstract

Pregnancy outcomes in patients with congenital heart disease have not been fully assessed in Korea. Forty-nine pregnancies that occurred in 34 women with congenital heart disease who registered at our hospital between September 1995 and April 2006 were reviewed. Spontaneous abortions occurred in two pregnancies at 6+1 and 7 weeks, and another two underwent elective pregnancy termination. One maternal death in puerperium occurred in a woman with Eisenmenger syndrome. Maternal cardiac complications were noted in 18.4%, pulmonary edema in 16.3%, symptomatic arrhythmia in 6.1%, deterioration of New York Heart Association (NYHA) functional class by > or =2 in 2.0%, and cardiac death in 2.0%. Independent predictors of adverse maternal cardiac events were an NYHA functional class of > or =3 (odds ratio [OR], 20.3), right ventricular dilation (OR, 21.2), and pulmonary hypertension (OR, 21.8). Neonatal complications occurred in 22.4% of pregnancies and included preterm delivery (16.3%), small for gestational age (12.2%), and neonatal death (2.0%). Independent predictors of adverse neonatal events were pulmonary hypertension (OR, 6.8) and NYHA functional class > or =3 (OR, 23.0). Pregnancy in women with congenital heart disease was found to be significantly associated with maternal cardiac and neonatal complications. Pre-pregnancy counseling and multidisciplinary care involving cardiologists and obstetricians are recommended for women with congenital heart disease contemplating pregnancy.

Keyword

Heart Defects, Congenital; Pregnancy Outcome; Risk Factors

MeSH Terms

Abortion, Spontaneous
Adult
Female
Heart Defects, Congenital/complications/*physiopathology
Humans
Korea
Multivariate Analysis
Obstetrics/methods
Odds Ratio
Pregnancy
Pregnancy Complications, Cardiovascular/physiopathology
Pregnancy Outcome

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