Perinatal outcomes among pregnant women with cardiac disease at tertiary care hospital, Riyadh, Saudi Arabia

BACKGROUND: Cardiac disease in pregnancy is associated with increased maternal and fetal morbidity and mortality. Functional status, particularly as assessed by the New York Heart Association (NYHA) classification, plays a critical role in predicting outcomes. OBJECTIVE: To evaluate maternal, fetal, and neonatal outcomes among pregnant women with cardiac disease managed at a tertiary care center and to assess the impact of functional cardiac status on outcomes. METHODS: This retrospective descriptive study included pregnant women with diagnosed cardiac disease who were managed at tertiary care hospital, over a six-year period. Descriptive statistics were used to summarize baseline characteristics and outcomes by using SPSS version 20. Comparison between NYHA Class I-II and III-IV groups were assessed using odds ratios (OR) with 95% confident intervals (CI). A p-value <0.05 was considered statistically significant. RESULTS: A total of 181 pregnancies complicated by maternal cardiac disease were included. Rheumatic heart disease was the most common acquired condition. Preterm birth occurred in 18.0% of NYHA I-II women compared to 55.6% in NYHA III-IV. ICU admission rates were 8.1% vs 44.4%, and cesarean delivery rates were 47.1% vs 77.8%, respectively. NICU admission was required for 23.8% of neonates, and congenital heart disease was identified in 25.2%. CONCLUSION: Functional cardiac status is significantly associated with adverse outcomes. Multidisciplinary, risk-stratified care is essential to optimize outcomes.