Pregnant
women with congenital heart defects (CHDs) are more likely to have
comorbidities and experience adverse events during delivery.

Using
multivariable logistic regression in a study published in the May 7 issue of
the Journal of the American College of Cardiology, Lauren E. Schlichting,
Ph.D., of the Hassenfeld Child Health Innovation Institute at Brown University
in Providence, Rhode Island, and colleagues compared comorbidities and adverse
delivery events for 22,881,691 deliveries identified in the 2008 to 2013
National Inpatient Sample.

In
addition, the authors examined the association between CHD severity and
presence of pulmonary hypertension (PH).

There were
17,729 deliveries to women with CHDs recorded (77.5 of 100,000 deliveries). The
researchers found that the odds of comorbidities, including PH, congestive
heart failure, and coronary artery disease, were greater for women with CHDs,
and greater odds of adverse events such as heart failure, arrhythmias,
thromboembolic events, preeclampsia, and placenta previa were also noted.

It was
more common for women with CHDs to experience cesarean section, induction, and
operative vaginal delivery; however, it was less common for them to experience
fetal distress. In regards to adverse events, PH was associated with heart
failure, hypertension in pregnancy, preeclampsia, and preterm delivery, but CHD
severity did not appear to affect most adverse events.

“As a
result, women with CHDs, especially severe forms, have complex health care
needs and increased health care utilization, as evidenced by their longer
hospital stays and higher delivery charges,” the authors wrote.

SOURCE: https://www.practiceupdate.com/C/83081/56

REFERENCE: Schlichting
et al: Maternal Comorbidities and Complications of Delivery in Pregnant Women
With Congenital Heart Disease; http://www.onlinejacc.org/content/73/17/2181