Key result
Idiopathic arrhythmias in pregnancy linked to higher symptom rates and ~190 g lower birth weight.
Why the study?
Idiopathic cardiac arrhythmias are common in pregnancy, yet current guidelines lack quantitative criteria for determining monitoring intensity in these patients.
Do pregnant women with idiopathic cardiac arrhythmias have different clinical features and pregnancy/delivery outcomes compared to women with uncomplicated pregnancies, and can a clinical significance score stratify their risk?
Cross-Sectional (n=80)
No
Do pregnant women with idiopathic cardiac arrhythmias have different clinical features and pregnancy/delivery outcomes compared to women with uncomplicated pregnancies, and can a clinical significance score stratify their risk?
In pregnant women with idiopathic arrhythmias, arrhythmia severity depends on type and quantitative burden rather than trimester, is associated with lower birth weight despite similar complication rates, and may be stratified using a novel 0-7 point clinical score.
Answers are grounded in this paper and cite their sources.
May inform closer fetal monitoring in arrhythmia pregnancies; leaves open prospective validation of the proposed risk score.
Resume. Background. Idiopathic cardiac arrhythmias are common in pregnancy, but current guidelines provide no quantitative criteria for deciding how intensively these women should be monitored. Aim. To describe the clinical, laboratory and Holter monitoring features of idiopathic arrhythmias in pregnancy, compare pregnancy outcomes with healthy pregnant women, and develop a clinical significance score with a management algorithm. Methods. A single-centre cross-sectional comparative study was conducted at Samarkand State Medical University in 2024-2026. The main group included 50 pregnant women with idiopathic arrhythmias, the control group 30 women with uncomplicated pregnancy. All women underwent clinical assessment, laboratory tests, ECG and echocardiography; women in the main group also underwent 24-hour Holter monitoring. Pregnancy and delivery outcomes were recorded. Results. The groups were comparable by age, parity and gestational age. Supraventricular premature beats (38.0%), sinus tachycardia (30.0%) and ventricular premature beats (26.0%) predominated. Symptoms were reported by 90.0% of the main group versus 36.7% of controls (p<0.001). Arrhythmic burden on Holter monitoring depended on the arrhythmia type (p<0.001) but not on the trimester (p=0.098-0.482). Complication and caesarean section rates did not differ between groups, but birth weight was lower in the main group (3263±42 vs 3454±47 g; p=0.003). A 0-7 point clinical significance score was proposed; applied to the main group, it classified 24.0% of women as low, 62.0% as intermediate and 14.0% as high clinical significance. Conclusion. In pregnant women with idiopathic arrhythmias, the severity of arrhythmia is determined by its type and quantitative burden rather than by gestational age. The proposed score and algorithm allow the intensity of follow-up to be individualised; their prognostic value requires prospective validation.
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Kobilova et al. (2026) conducted a cross-sectional in Idiopathic cardiac arrhythmias in pregnancy (n=80). Idiopathic cardiac arrhythmias in pregnancy vs. Uncomplicated pregnancy (healthy pregnant women) was evaluated on Clinical symptoms and pregnancy/delivery outcomes (including neonatal birth weight) (p=<0.001). Idiopathic arrhythmias in pregnancy were associated with higher symptom rates and lower neonatal birth weight than uncomplicated pregnancies.
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