The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease: A prospective cohort study

BACKGROUND: Premature ventricular contractions (PVCs) may increase during pregnancy, however, few studies have evaluated the relationship between PVCs and the pregnant outcomes. HYPOTHESIS: PVCs may increase the adverse fetal/neonatal outcomes in pregnant women. METHODS: Six thousand one hundred and forty-eight pregnant women were prospectively enrolled in our center between 2017 and 2019 in the study. The average PVC burden was determined by calculating the number of PVCs in total beats. Those who had a PVC burden >0.5% were divided into two groups based on the presence or absence of adverse fetal or neonatal events. The adverse outcomes were compared between the groups to assess the impact of PVCs on pregnancy. RESULTS: A total of 103 (1.68%) women with a PVC burden >0.5% were recorded. Among them, 17 adverse events (12 cases) were documented, which was significantly higher than that among women without PVCs (11.65% vs. 2.93%, p < .01). The median PVC burden among pregnant women with PVCs was 2.84% (1.02%-6.1%). Furthermore, compared with that of the women without adverse events, the median PVC burden of women with adverse fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%, p < .01). Multivariate logistic regression analysis demonstrated that not the LVEF, heart rate and bigeminy, but only the PVC burden was associated with adverse fetal or neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI [1.11-1.61], p < .01). CONCLUSIONS: Frequent PVCs have adverse effects on pregnancy, and the PVC burden might be an important factor associated with adverse fetal and neonatal outcomes among pregnant women with PVCs.