Pregnancy outcomes and relative risk factors among Chinese women with congenital heart disease

OBJECTIVE: To summarize pregnancy outcomes among a cohort of Chinese women with congenital heart disease (CHD) and to identify predictive risk factors for maternal, fetal, and neonatal complications. METHODS: A retrospective analysis of 529 women with CHD who gave birth at the Shanghai Obstetrical Cardiology Intensive Care Center, Shanghai, China, between January 1, 1993, and September 30, 2010. Maternal, fetal, and neonatal complications were evaluated for these women. RESULTS: Maternal cardiac complications were reported in 33 (6.2%) of the women, whereas fetal and neonatal complications were reported in 145 (27.4%). The factors found to be significantly predictive for maternal cardiac complications were cardiac events before pregnancy (odds ratio OR 36.811), New York Heart Association functional class greater than II (OR 27.702), oxygen saturation below 90% (OR 7.506), and left ventricular obstruction (aorta stenosis) (OR 2.408). Factors significantly predictive for fetal and neonatal complications were New York Heart Association functional class greater than II (OR 20.12), oxygen saturation below 90% (OR 3.78), and pulmonary arterial hypertension (systolic pressure ≥ 50 mm Hg) (OR 3.42). CONCLUSION: Identification of maternal, fetal, and neonatal complications among women with CHD may guide medical intervention and therefore reduce pregnancy-associated risk for these patients.