Key result
Marfan syndrome in pregnancy is linked to ~115% greater premature birth risk alongside arrhythmias and pneumothorax.
Why the study?
Does Marfan syndrome increase the risk of adverse maternal and fetal outcomes during pregnancy compared to women without the condition?
Cohort (n=7,094,400)
Yes
Does Marfan syndrome increase the risk of adverse maternal and fetal outcomes during pregnancy compared to women without the condition?
Pregnant women with Marfan syndrome face significantly elevated risks of adverse maternal and fetal events, including arrhythmias, pneumothorax, and premature birth, underscoring the need for specialized preconception counseling and tertiary care.
Answers are grounded in this paper and cite their sources.
May inform risk stratification in Marfan pregnancies; hypothesis-generating and requires prospective validation before changing practice.
OBJECTIVE: Marfan syndrome (MFS) is a rare connective tissue disease with significant risk for adverse cardiovascular outcomes. Our objective was to evaluate pregnancy and cardiovascular outcomes in pregnant women with MFS. STUDY DESIGN: We conducted a population-based retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP NIS) database from 2003 to 2010. We used unconditional regression analyses to compare maternal and fetal outcomes among pregnancies in women with and without MFS. RESULTS: Out of the 7,094,400 births in our cohort, 339 deliveries were to women with MFS. There was one maternal death and six aortic dissections among women with MFS. Births to women with MFS were more likely to be premature, odds ratio (OR) 2.15 (1.60-2.89), have intrauterine growth restricted and small for gestational age infants, OR 2.06 (1.24-3.43). Women with MFS were more likely to deliver by cesarean section, OR 1.91 (1.53-2.38) and were at higher risk of major morbidities including cardiac arrhythmias, OR 10.64 (5.49-20.61) and pneumothorax, OR 51.95 (6.18, 437.10). CONCLUSION: Pregnant women with MFS are at a particularly high risk of adverse pregnancy and cardiovascular events. Preconception counseling should take these risks into consideration and appropriate pregnancy care in tertiary centers should be considered.
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Hassan et al. (2014) conducted a cohort in Marfan syndrome in pregnancy (n=7,094,400). Marfan syndrome vs. Women without Marfan syndrome was evaluated on Premature birth (OR 2.15, 95% CI 1.60-2.89). Pregnant women with Marfan syndrome had a higher risk of premature birth, cardiac arrhythmias, and pneumothorax compared to those without.
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