Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts
Objectives Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts.Methods This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with str...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-09-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/9/2/e002117.full |
| _version_ | 1817982537610297344 |
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| author | Yan Liu Nikhil Sharma Stavros E Mountantonakis Umair Ansari Tia Bimal Kristie Coleman Rosaline Ma Dillon Gurciullo Elliot Wolf Roland Hentz |
| author_facet | Yan Liu Nikhil Sharma Stavros E Mountantonakis Umair Ansari Tia Bimal Kristie Coleman Rosaline Ma Dillon Gurciullo Elliot Wolf Roland Hentz |
| author_sort | Yan Liu |
| collection | DOAJ |
| description | Objectives Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts.Methods This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with structurally abnormal hearts, we identified women with an arrhythmic event and randomly subsampled the rest of the cohort to create a control group of 1025 patients. Multivariate analysis was performed to examine the association between arrhythmias and the incidence of caesarean section (CS), preterm labour (PTL), admission to the neonatal intensive care unit and longer length of stay (LOS).Results Of 1 41 769 women admitted in labour with a structurally normal heart, 137 had at least one arrhythmic event (0.097%). Supraventricular tachycardia (SVT), atrial fibrillation/flutter (AF) and frequent premature ventricular complexes or non-sustained ventricular tachycardia (VA) were present in 65 (0.046%), 22 (0.016%) and 46 (0.032%) women, respectively. Arrhythmia was previously diagnosed in 58.0% SVT cases but only in 9.7% AF and 8.1% VA cases. After adjusting for age, parity and comorbidities, the presence of any arrhythmia was an independent predictor of CS (OR 1.7 95% CI 1.2 to 2.5), PTL (OR 1.8, CI 1.1 to 3.0) and LOS (mean ratio 1.6, CI 1.4 to 1.8). This association was driven by presence of SVT and AF, whereas VAs were not associated with adverse outcomes.Conclusions Arrhythmias, specifically SVT and AF, during labour in women with structurally normal heart are independently associated with adverse obstetrical outcomes. |
| first_indexed | 2024-04-13T23:22:04Z |
| format | Article |
| id | doaj.art-f160e1b065154b9f80bd54e21880718e |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-04-13T23:22:04Z |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-f160e1b065154b9f80bd54e21880718e2022-12-22T02:25:13ZengBMJ Publishing GroupOpen Heart2053-36242022-09-019210.1136/openhrt-2022-002117Prevalence and clinical significance of arrhythmias during labour in women with structurally normal heartsYan Liu0Nikhil Sharma1Stavros E Mountantonakis2Umair Ansari3Tia Bimal4Kristie Coleman5Rosaline Ma6Dillon Gurciullo7Elliot Wolf8Roland Hentz9Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USADepartment of Cardiac Electrophysiology, Northwell Health, Lenox Hill Heart and Vascular Institute, New York, New York, USADepartment of Cardiac Electrophysiology, Northwell Health, Lenox Hill Heart and Vascular Institute, New York, New York, USADepartment of Cardiac Electrophysiology, Northwell Health, Lenox Hill Heart and Vascular Institute, New York, New York, USADepartment of Cardiac Electrophysiology, Northwell Health, Lenox Hill Heart and Vascular Institute, New York, New York, USADepartment of Cardiology, Lenox Hill Hospital, New York City, New York, USADepartment of Cardiology, Lenox Hill Hospital, New York City, New York, USADepartment of Obstetrics & Gynecology, Lenox Hill Hospital, New York City, New York, USADepartment of Cardiology, Lenox Hill Hospital, New York City, New York, USAQuantitative Intelligence, Feinstein Institutes for Medical Research, Manhasset, New York, USAObjectives Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts.Methods This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with structurally abnormal hearts, we identified women with an arrhythmic event and randomly subsampled the rest of the cohort to create a control group of 1025 patients. Multivariate analysis was performed to examine the association between arrhythmias and the incidence of caesarean section (CS), preterm labour (PTL), admission to the neonatal intensive care unit and longer length of stay (LOS).Results Of 1 41 769 women admitted in labour with a structurally normal heart, 137 had at least one arrhythmic event (0.097%). Supraventricular tachycardia (SVT), atrial fibrillation/flutter (AF) and frequent premature ventricular complexes or non-sustained ventricular tachycardia (VA) were present in 65 (0.046%), 22 (0.016%) and 46 (0.032%) women, respectively. Arrhythmia was previously diagnosed in 58.0% SVT cases but only in 9.7% AF and 8.1% VA cases. After adjusting for age, parity and comorbidities, the presence of any arrhythmia was an independent predictor of CS (OR 1.7 95% CI 1.2 to 2.5), PTL (OR 1.8, CI 1.1 to 3.0) and LOS (mean ratio 1.6, CI 1.4 to 1.8). This association was driven by presence of SVT and AF, whereas VAs were not associated with adverse outcomes.Conclusions Arrhythmias, specifically SVT and AF, during labour in women with structurally normal heart are independently associated with adverse obstetrical outcomes.https://openheart.bmj.com/content/9/2/e002117.full |
| spellingShingle | Yan Liu Nikhil Sharma Stavros E Mountantonakis Umair Ansari Tia Bimal Kristie Coleman Rosaline Ma Dillon Gurciullo Elliot Wolf Roland Hentz Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts Open Heart |
| title | Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| title_full | Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| title_fullStr | Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| title_full_unstemmed | Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| title_short | Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| title_sort | prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts |
| url | https://openheart.bmj.com/content/9/2/e002117.full |
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