Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease
Background Pregnant women with underlying heart disease (HD) are at increased risk for adverse maternal, obstetric, and neonatal outcomes. Methods and Results Inpatient maternal delivery admissions and linked neonatal stays for women with cardiomyopathy, adult congenital HD, pulmonary hypertension (...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.009395 |
| _version_ | 1828315680877838336 |
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| author | Amanda Owens Jie Yang Lizhou Nie Fabio Lima Cecilia Avila Kathleen Stergiopoulos |
| author_facet | Amanda Owens Jie Yang Lizhou Nie Fabio Lima Cecilia Avila Kathleen Stergiopoulos |
| author_sort | Amanda Owens |
| collection | DOAJ |
| description | Background Pregnant women with underlying heart disease (HD) are at increased risk for adverse maternal, obstetric, and neonatal outcomes. Methods and Results Inpatient maternal delivery admissions and linked neonatal stays for women with cardiomyopathy, adult congenital HD, pulmonary hypertension (PH), and valvular HD were explored utilizing the Statewide Planning and Research Cooperative System (New York), January 1, 2000, through December 31, 2014, with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM). Maternal major adverse cardiac events, neonatal adverse clinical events (NACE), and obstetric complications were recorded. Outcomes were compared using multiple logistic regression modeling. Among 2 284 044 delivery admissions, 3871 women had HD; 676 (17%) had cardiomyopathy, 1528 (40%) had valvular HD, 1367 (35%) had adult congenital HD, and 300 (8%) had PH. Major adverse cardiac events occurred in 16.1% of women with HD, with most in the cardiomyopathy (45.9%) and PH (25%) groups. NACE was more common in offspring of women with HD (18.4% versus 7.1%), with most in the cardiomyopathy (30.0%) and PH (25.0%) groups. Increased risk of NACE was noted for women with HD (odds ratio [OR]: 2.8; 95% confidence interval [CI], 2.5–3.0), with the highest risk for those with cardiomyopathy (OR: 5.9; 95% CI, 5.0–7.0) and PH (OR: 4.5; 95% CI, 3.4–5.9). Preeclampsia (OR: 5.1; 95% CI, 3.0–8.6), major adverse cardiac events (OR: 2.3; 95% CI, 1.8–2.9), preexisting diabetes mellitus (OR: 4.3; 95% CI, 1.5–12.3), and obstetric complications (OR: 2.9; 95% CI, 1.7–5.2) were independently associated with higher NACE risk. Conclusions Neonatal complications were higher in offspring of pregnant women with HD, particularly cardiomyopathy and PH. Preeclampsia, major adverse cardiac events, obstetric complications, and preexisting diabetes mellitus were independently associated with a higher risk of NACE. |
| first_indexed | 2024-04-13T17:03:19Z |
| format | Article |
| id | doaj.art-7dbef171a5714b33811589a987c0435b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:03:19Z |
| publishDate | 2018-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7dbef171a5714b33811589a987c0435b2022-12-22T02:38:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-11-0172110.1161/JAHA.118.009395Neonatal and Maternal Outcomes in Pregnant Women With Cardiac DiseaseAmanda Owens0Jie Yang1Lizhou Nie2Fabio Lima3Cecilia Avila4Kathleen Stergiopoulos5Division of Cardiovascular Medicine Department of Medicine State University of New York Stony Brook University Medical Center Stony Brook NYDepartment of Family, Population and Preventive Medicine Stony Brook University Medical Center Stony Brook NYDepartment of Applied Mathematics and Statistics Stony Brook University Stony Brook NYDepartment of Medicine Brown University Rhode Island Hospital Providence RIDepartment of Obstetrics, Gynecology and Reproductive Medicine University Medical Center Stony Brook NYDivision of Cardiovascular Medicine Department of Medicine State University of New York Stony Brook University Medical Center Stony Brook NYBackground Pregnant women with underlying heart disease (HD) are at increased risk for adverse maternal, obstetric, and neonatal outcomes. Methods and Results Inpatient maternal delivery admissions and linked neonatal stays for women with cardiomyopathy, adult congenital HD, pulmonary hypertension (PH), and valvular HD were explored utilizing the Statewide Planning and Research Cooperative System (New York), January 1, 2000, through December 31, 2014, with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM). Maternal major adverse cardiac events, neonatal adverse clinical events (NACE), and obstetric complications were recorded. Outcomes were compared using multiple logistic regression modeling. Among 2 284 044 delivery admissions, 3871 women had HD; 676 (17%) had cardiomyopathy, 1528 (40%) had valvular HD, 1367 (35%) had adult congenital HD, and 300 (8%) had PH. Major adverse cardiac events occurred in 16.1% of women with HD, with most in the cardiomyopathy (45.9%) and PH (25%) groups. NACE was more common in offspring of women with HD (18.4% versus 7.1%), with most in the cardiomyopathy (30.0%) and PH (25.0%) groups. Increased risk of NACE was noted for women with HD (odds ratio [OR]: 2.8; 95% confidence interval [CI], 2.5–3.0), with the highest risk for those with cardiomyopathy (OR: 5.9; 95% CI, 5.0–7.0) and PH (OR: 4.5; 95% CI, 3.4–5.9). Preeclampsia (OR: 5.1; 95% CI, 3.0–8.6), major adverse cardiac events (OR: 2.3; 95% CI, 1.8–2.9), preexisting diabetes mellitus (OR: 4.3; 95% CI, 1.5–12.3), and obstetric complications (OR: 2.9; 95% CI, 1.7–5.2) were independently associated with higher NACE risk. Conclusions Neonatal complications were higher in offspring of pregnant women with HD, particularly cardiomyopathy and PH. Preeclampsia, major adverse cardiac events, obstetric complications, and preexisting diabetes mellitus were independently associated with a higher risk of NACE.https://www.ahajournals.org/doi/10.1161/JAHA.118.009395adult congenital heart diseasecardiomyopathypregnancypulmonary hypertensionvalve |
| spellingShingle | Amanda Owens Jie Yang Lizhou Nie Fabio Lima Cecilia Avila Kathleen Stergiopoulos Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adult congenital heart disease cardiomyopathy pregnancy pulmonary hypertension valve |
| title | Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease |
| title_full | Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease |
| title_fullStr | Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease |
| title_full_unstemmed | Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease |
| title_short | Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease |
| title_sort | neonatal and maternal outcomes in pregnant women with cardiac disease |
| topic | adult congenital heart disease cardiomyopathy pregnancy pulmonary hypertension valve |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.009395 |
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