July 10th, 2020

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Perinatal Outcomes Among Women with Congenital Heart Disease
Authors:  Martina L. Badell, M.D., Michael Lindsay, M.D., M.P.H., Tammy L. Loucks, M.P.H., Dr.P.H., Jessica C. Arluck, M.D., and Wendy Book, M.D.
  OBJECTIVE: To compare perinatal outcomes between women with and without congenital heart disease (CHD). Due to advances in cardiac care, the number of adults with CHD is growing. Pregnant women with CHD face a unique set of challenges.

STUDY DESIGN: A prospective cohort study comparing perinatal outcomes between women with and without CHD delivered at a single tertiary care center. We examined and compared maternal characteristics and perinatal outcomes.

RESULTS: Forty-seven women with CHD and 146 without CHD were enrolled. The women had similar baseline demographics. The rate of preterm birth (PTB) was significantly higher in women with CHD (25.5% vs. 6.8%, respectively, RR 3.7, 95% CI 1.7–8.1). The route of delivery and rates of adverse obstetrical outcomes were similar. Women with CHD were more likely to undergo labor induction as compared to women without CHD (44.7% vs. 27.4%, respectively, RR 2.02, 95% CI 1.4–2.9). In the women with CHD, 57% of induc-tions were indicated for maternal cardiac decompensation. Women with CHD had an increased rate of CHD in their offspring (6.4% vs. 0.7%, p=0.04).

CONCLUSION: Maternal CHD is associated with an increased risk of PTB, induction of labor, and CHD in their offspring as compared to women without CHD.
Keywords:  congenital abnormalities, congenital defects, congenital heart defect, congenital heart disease, heart decompensation, maternal health, pregnancy, preterm birth
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