Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study
Abstract Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejectio...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-26606-z |
| _version_ | 1797958759526432768 |
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| author | Laura Ormesher Sarah Vause Suzanne Higson Anna Roberts Bernard Clarke Stephanie Curtis Victoria Ordonez Faiza Ansari Thomas R. Everett Claire Hordern Lucy Mackillop Victoria Stern Tessa Bonnett Alice Reid Suzanne Wallace Ebruba Oyekan Hannah Douglas Matthew Cauldwell Maya Reddy Kirsten Palmer Maggie Simpson Janet Brennand Laura Minns Leisa Freeman Sarah Murray Nirmala Mary James Castleman Katie R. Morris Elizabeth Haslett Christopher Cassidy Edward D. Johnstone Jenny E. Myers |
| author_facet | Laura Ormesher Sarah Vause Suzanne Higson Anna Roberts Bernard Clarke Stephanie Curtis Victoria Ordonez Faiza Ansari Thomas R. Everett Claire Hordern Lucy Mackillop Victoria Stern Tessa Bonnett Alice Reid Suzanne Wallace Ebruba Oyekan Hannah Douglas Matthew Cauldwell Maya Reddy Kirsten Palmer Maggie Simpson Janet Brennand Laura Minns Leisa Freeman Sarah Murray Nirmala Mary James Castleman Katie R. Morris Elizabeth Haslett Christopher Cassidy Edward D. Johnstone Jenny E. Myers |
| author_sort | Laura Ormesher |
| collection | DOAJ |
| description | Abstract Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fraction < 55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2–7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7–8.2], p = 0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (< 37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, p = 0.03; 15.2% vs. 5.5%, p < 0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal ß blockers (n = 116) were associated with lower birthweight Z score (adjusted difference − 0.31 [95% C.I. − 0.61 to − 0.01], p = 0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the population’s background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use. |
| first_indexed | 2024-04-11T00:23:16Z |
| format | Article |
| id | doaj.art-b7db133d1b5f4490ad571a2dde9ac132 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T00:23:16Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-b7db133d1b5f4490ad571a2dde9ac1322023-01-08T12:10:39ZengNature PortfolioScientific Reports2045-23222023-01-0113111410.1038/s41598-022-26606-zPrevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort studyLaura Ormesher0Sarah Vause1Suzanne Higson2Anna Roberts3Bernard Clarke4Stephanie Curtis5Victoria Ordonez6Faiza Ansari7Thomas R. Everett8Claire Hordern9Lucy Mackillop10Victoria Stern11Tessa Bonnett12Alice Reid13Suzanne Wallace14Ebruba Oyekan15Hannah Douglas16Matthew Cauldwell17Maya Reddy18Kirsten Palmer19Maggie Simpson20Janet Brennand21Laura Minns22Leisa Freeman23Sarah Murray24Nirmala Mary25James Castleman26Katie R. Morris27Elizabeth Haslett28Christopher Cassidy29Edward D. Johnstone30Jenny E. Myers31Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of ManchesterSaint Mary’s Hospital, Manchester University NHS Foundation TrustManchester Heart Centre, Manchester University NHS Foundation TrustSaint Mary’s Hospital, Manchester University NHS Foundation TrustManchester Heart Centre, Manchester University NHS Foundation TrustBristol Heart Institute, Bristol Royal InfirmaryBristol Heart Institute, Bristol Royal InfirmaryLeeds Teaching Hospitals NHS TrustLeeds Teaching Hospitals NHS TrustOxford University Hospitals NHS Foundation TrustOxford University Hospitals NHS Foundation TrustAcademic Unit of Developmental and Reproductive Medicine, University of SheffieldAcademic Unit of Developmental and Reproductive Medicine, University of SheffieldDepartment of Obstetrics, Nottingham University Hospitals NHS TrustDepartment of Obstetrics, Nottingham University Hospitals NHS TrustGuy’s and St Thomas’ NHS Foundation TrustGuy’s and St Thomas’ NHS Foundation TrustSt George’s University Hospitals NHS Foundation TrustMonash Women’s, Monash Health, Monash UniversityMonash Women’s, Monash Health, Monash UniversityScottish Adult Congenital Cardiac Service, Golden Jubilee National HospitalScottish Adult Congenital Cardiac Service, Golden Jubilee National HospitalDepartment of Cardiology, Norfolk& Norwich University Hospital Foundation TrustDepartment of Cardiology, Norfolk& Norwich University Hospital Foundation TrustRoyal Infirmary of Edinburgh, NHS Lothian University Hospitals DivisionRoyal Infirmary of Edinburgh, NHS Lothian University Hospitals DivisionBirmingham Women’s and Children’s Hospital NHS Foundation TrustBirmingham Women’s and Children’s Hospital NHS Foundation TrustBlackpool Teaching Hospitals NHS Foundation TrustBlackpool Teaching Hospitals NHS Foundation TrustMaternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of ManchesterMaternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of ManchesterAbstract Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fraction < 55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2–7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7–8.2], p = 0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (< 37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, p = 0.03; 15.2% vs. 5.5%, p < 0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal ß blockers (n = 116) were associated with lower birthweight Z score (adjusted difference − 0.31 [95% C.I. − 0.61 to − 0.01], p = 0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the population’s background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use.https://doi.org/10.1038/s41598-022-26606-z |
| spellingShingle | Laura Ormesher Sarah Vause Suzanne Higson Anna Roberts Bernard Clarke Stephanie Curtis Victoria Ordonez Faiza Ansari Thomas R. Everett Claire Hordern Lucy Mackillop Victoria Stern Tessa Bonnett Alice Reid Suzanne Wallace Ebruba Oyekan Hannah Douglas Matthew Cauldwell Maya Reddy Kirsten Palmer Maggie Simpson Janet Brennand Laura Minns Leisa Freeman Sarah Murray Nirmala Mary James Castleman Katie R. Morris Elizabeth Haslett Christopher Cassidy Edward D. Johnstone Jenny E. Myers Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study Scientific Reports |
| title | Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study |
| title_full | Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study |
| title_fullStr | Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study |
| title_full_unstemmed | Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study |
| title_short | Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study |
| title_sort | prevalence of pre eclampsia and adverse pregnancy outcomes in women with pre existing cardiomyopathy a multi centre retrospective cohort study |
| url | https://doi.org/10.1038/s41598-022-26606-z |
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