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Congenital heart disease involves risks during pregnancy

Pregnant women with congenital heart disease have a higher risk of premature delivery or infant mortality than women who do not.

Congenital heart disease involves risks during pregnancy

Pregnant women with congenital heart disease have a higher risk of premature delivery or infant mortality than women who do not. In many pregnant women born with heart defects, the increased burden imposed on their circulatory system by pregnancy may lead to major effects on their health and that of the baby. Dutch researchers from the University Medical Centre, Groningen, reviewed existing studies of complications during pregnancies in women with congenital heart disease. The outcome of 2491 pregnancies in women with different types of congenital heart disease included 377 miscarriages (15%) and 114 elective abortions (5%). Clinically significant heart failure was the most common complication, affecting almost 5 per cent of the pregnancies. Irregular cardiac rhythm and other heart-related events, which are rarely seen in healthy pregnant women, were found in 11 per cent of the cases. However, the reported heart failure rate could be an underestimation, considering that early heart failure was an important reason for elective abortion. The findings suggest that disorders that complicated pregnancy, including high blood pressure and blood clots, were less well documented but rates were higher than normal. The overall offspring mortality was 4 per cent, which was partly related to the relatively high premature birth rate (16 per cent) and the recurrence of congenital heart disease, which occurred in up to 8 per cent of babies, depending upon the specific defect. In today's world, fetal and perinatal mortality is below 1 per cent; thereby the chance of offspring mortality in pregnant women with birth defects of the heart, on an average, increased by 4 times. Nevertheless, most of the pregnancies were successful, despite the higher rates of premature delivery, and more children being small for gestational age
Journal of the American College of Cardiology,
June 2007
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