Peripartum management of pregnant women with congenital heart disease

Keiko Yamasaki, Hiroyuki Sawatari, Nao Konagai, Chizuko A. Kamiya, Jun Yoshimatsu, Jun Muneuchi, Mamie Watanabe, Terunobu Fukuda, Atsushi Mizuno, Ichiro Sakamoto, Kenichiro Yamamura, Tomoko Ohkusa, Hiroyuki Tsutsui, Koichiro Niwa, Akiko Chishaki

Research output: Contribution to journalArticle

Abstract

Background: The average maternal age at delivery, and thus the associated maternal risk are increasing including in women with congenital heart disease (CHD). A comprehensive management approach is therefore required for pregnant women with CHD. The present study aimed to investigate the factors determining peripartum safety in women with CHD. Methods and Results: We retrospectively collected multicenter data for 217 pregnant women with CHD (age at delivery: 31.4±5.6 years; NYHA classifications I and II: 88.9% and 7.4%, respectively). CHD severity was classified according to the American College of Cardiology/American Heart Association guidelines as simple (n=116), moderate complexity (n=69), or great complexity (n=32). Cardiovascular (CV) events (heart failure: n=24, arrhythmia: n=9) occurred in 30 women during the peripartum period. Moderate or great complexity CHD was associated with more CV events during gestation than simple CHD. CV events occurred earlier in women with moderate or great complexity compared with simple CHD. Number of deliveries (multiparity), NYHA functional class, and severity of CHD were predictors of CV events. Conclusions: This study identified not only the severity of CHD according to the ACC/AHA and NYHA classifications, but also the number of deliveries, as important predictive factors of CV events in women with CHD. This information should be made available to women with CHD and medical personnel to promote safe deliveries.

Original languageEnglish
Pages (from-to)2257-2264
Number of pages8
JournalCirculation Journal
Volume83
Issue number11
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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