Key result
Cyanotic heart disease during pregnancy was associated with higher incidences of stillbirths (13.6% vs 0.8%) and small for gestational age infants (36.4% vs 6.9%) compared to acyanotic disease.
Why the study?
Does cyanotic congenital heart disease worsen maternal and fetal outcomes compared to acyanotic congenital heart disease in pregnant women?
Cohort (n=275)
Does cyanotic congenital heart disease worsen maternal and fetal outcomes compared to acyanotic congenital heart disease in pregnant women?
Pregnancies in women with cyanotic congenital heart disease are associated with significantly worse fetal outcomes, including higher rates of stillbirths and small for gestational age infants, compared to those with acyanotic heart disease.
Answers are grounded in this paper and cite their sources.
Highlights need for specialized fetal surveillance in cyanotic congenital heart disease pregnancies; leaves open independent causal role of cyanosis.
Two hundred and seventy five pregnancies in patients with congenital heart disease during 1980-1996 were analyzed retrospectively. Maternal and perinatal outcome was compared in 251 pregnancies of women with acyanotic and 24 pregnancies of women with cyanotic heart disease. Congenital heart disease was diagnosed during the index pregnancy in 26.1% of patients and the majority (88.4%) were in NYHA classes 1 and 2. Atrial septal defect (27.7%) was the most common lesion in women with acyanotic heart disease and the majority with cyanotic heart disease had Eisenmenger syndrome, 13 of 21 (61.9%). Sixty pregnancies occurred in patients with surgically corrected lesions (acyanotic, 56; cyanotic, 4). The incidences of abortions (8.3%), stillbirths (13.6%) and small for gestational age (SGA) (36.4%) were higher in cyanotic heart disease compared to acyanotic heart disease (stillbirth, 0.8%; SGA, 6.9%). There was a statistically significant difference in mean maternal age, mean gestational age and mean birth-weight in the surgically corrected and noncorrected lesions in both acyanotic and cyanotic heart disease. There was 1 maternal death in a woman with Eisenmenger syndrome.
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Sawhney et al. (1998) conducted a cohort in Congenital heart disease (n=275). Cyanotic congenital heart disease vs. Acyanotic congenital heart disease was evaluated on Stillbirths. Cyanotic heart disease during pregnancy was associated with higher incidences of stillbirths (13.6% vs 0.8%) and small for gestational age infants (36.4% vs 6.9%) compared to acyanotic disease.
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