Congenital heart defects can confer cardiac and obstetric complications during pregnancy


Disclosures: The authors do not report any relevant financial disclosures.


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Women with congenital heart defects were more likely to suffer from heart and obstetric complications during pregnancy than women without heart defects, the researchers reported.

In addition, 4% of these women were prescribed potentially teratogenic or fetotoxic drugs and only half had a full guideline recommended echocardiogram, according to results published in Circulation: cardiovascular quality and results.

Pregnant
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Researchers assessed U.S. data on health care claims from 2007 to 2014 of women aged 15 to 44 with (n = 2,056) and without (n = 1,374,982) congenital heart defects and private insurance. . For this analysis, congenital heart defects were defined as at least one inpatient code or at least two outpatient codes greater than 30 days apart, documented outside of pregnancy and classified as serious or non-serious.

Researchers found that women with congenital heart defects had a higher prevalence of unwanted obstetric disorders (adjusted prevalence ratio [aPR] = 1.3; 95% CI, 1.2-1.4), heart disease (aPR = 10.2; 95% CI, 9.1-11.4), stillbirth (aPR = 1.6; 95% CI, 1.1-2.4) preterm delivery (aPR = 1.6; 95% CI, 1.4-1.8) and unfavorable conditions overall (aPR = 1.9; 95% CI, 1.7-2.1) compared to women without abnormalities.

Additionally, from the women’s last menstrual period until 90 days after childbirth, 56% of patients with congenital heart defects underwent full echocardiograms during pregnancy according to guidelines recommended by the American Heart Association.

Additionally, about 4% of women with congenital heart defects have filled at least one potentially teratogenic or fetotoxic cardiac prescription.

“We found that women with congenital heart defects (all, severe only and not severe only) had a higher prevalence of adverse pregnancy outcomes and conditions than women without congenital heart defects, but only half received recommended full echocardiograms during pregnancy or up to 90 days after delivery. ” Karrie F. Downing, MPH, of the Congenital and Developmental Disorders Division at CDC, and colleagues wrote. “The AHA / American College of Cardiology and American College of Obstetrics and Gynecology recommendations for assessing heart health, including performing echocardiograms and reviewing drugs for benefits and risks, in pregnant women with congenital heart defects can lead to early identification, prevention or treatment of adverse reactions. conditions and better pregnancy outcomes.

In other results, women with severe congenital heart defects overall had more unfavorable conditions (aPR = 1.5; 95% CI: 1.2-1.9) compared to women with non-serious malformations.

“This is the first analysis, to our knowledge, examining receipt of AHA / ACC recommended cardiac evaluations and filled prescriptions for potentially teratogenic or fetotoxic cardiac drugs during pregnancy,” the researchers wrote.