Factors associated with adverse pregnancy outcomes in known cardiac patients

Background: Cardiac disease is a major cause of maternal illness and death during pregnancy. The burden is especially high in regions with limited healthcare resources, where delayed diagnosis and poor access to care increase the risk of adverse outcomes. Objective was to assess the frequency of adverse outcomes and factors related to maternal adverse outcomes in pregnant cardiac patients. Methods: This descriptive case series was carried out in the Department of obstetrics and gynecology, services hospital, Lahore, from December 2025 to February 2026. A total of 100 pregnant women with cardiac disease beyond 16 weeks of gestation were included. Demographic, obstetric, and clinical data including type of cardiac disease, New York Heart Association (NYHA) functional class, and treatment history were recorded along with maternal and fetal outcomes. Data were analyzed using SPSS version 21. Associations between variables and outcomes were assessed using the chi-square test, with statistical significance set at p < 0.05. Results: The mean age was 29.17 ± 4.91 years, mean gestational age 32.54 ± 3.29 weeks, and mean BMI 27.11 ± 3.33 kg/m². Rheumatic heart disease was most common (38%). Stillbirth (64%) and maternal mortality (57%) were the major adverse outcomes. ICU admission was 21% and prolonged hospital stay 22%. Outcomes were significantly associated with age, BMI, gestational age, parity, booking status, and socioeconomic factors (p < 0.05). High-risk groups included younger, prim gravida, normal BMI, and un-booked patients. Conclusion: Pregnant women with cardiac disease face high rates of maternal mortality (57%) and stillbirth (64%), influenced by factors such as maternal age, BMI, parity, booking status, and socioeconomic conditions. Early detection and timely intervention can improve outcomes.