Safe pregnancy, childbirth for women born with heart defects | Health Info

By Robert Preidt, Health Day reporter

(Health day)

MONDAY, October 18, 2021 (HealthDay News) – Women born with heart defects can be reassured by a new study that finds they are at no increased health risk during pregnancy and childbirth.

Doctors can often advise these women against getting pregnant because of the potential risks to them and their babies, but so far those risks have not been clear, researchers say.

“The most important finding from our study is that many women born with a congenital heart defect are able to go through pregnancy and give birth safely. This is important because only a few decades ago, many women did not. would not even have reached adulthood themselves, ”said study co-author Dr. Astrid Lammers.

“It is very encouraging to see that so many mothers with congenital heart defects can give birth to healthy children,” added Lammers, consultant for pediatric cardiology at the University Hospital in Münster, in Germany.

Still, medical care and expert advice are essential, the study’s authors said.

For the study, the researchers analyzed data from more than 7,500 pregnancies among more than 4,000 German women with a congenital heart defect. The investigators compared them to more than 11,200 pregnancies in a control group of about 6,500 women without a heart defect.

According to the report, no one with a congenital heart defect died during pregnancy and for up to 90 days after childbirth, while a woman in the control group died.

Complications in all women were generally low. However, women with a congenital heart defect had significantly higher rates of stroke (1.13% vs. 0.17%), heart failure (0.84% ​​vs. 0.03%), and arrhythmias. cardiac (0.82% vs. 0.12%) compared to the other group.

Women with a heart defect also had a higher rate of cesarean delivery than those in the control group: 41% versus 32%.

Compared to babies in the control group, those born to mothers with a congenital heart defect had a higher risk of stillbirth, death in the first month of life, and low or extremely low birth weight. They were also more likely to be born prematurely, to need mechanical ventilation, to have major visible abnormalities, and to have Down syndrome or other genetic syndromes.

Babies born to mothers with a congenital heart defect were also more likely to have a congenital heart defect, and more likely to require heart surgery with artificial heart-lung support by age 6.

The complexity of the mother’s heart defect, high blood pressure, heart failure, anticoagulant therapy with vitamin K antagonists in the year before pregnancy, and previous fertility treatment were all significant predictors. problems in babies of mothers with a heart defect, according to the study, which was published on Oct. 12 in the European Heart Journal.

“We are reporting health issues around the time of birth that are relevant and important. However, with advanced neonatal support and techniques, the majority of these issues can be overcome with medical support, albeit with limited care. surgery and prolonged hospitalization, ”Lammers said. in a press release.

The fact that there were no deaths among women with congenital heart defects was “unexpected and fantastic news,” Jolien Roos-Hesselink and Dr Karishma Ramlakhan wrote in an accompanying editorial.

This is “an important message that should lead to a change in policy, from a potentially very dangerous approach to pregnancy, to a consideration of pregnancy as relatively safe and to an explanation of possible risks, provided women in [the very highest risk group] should not get pregnant, “according to two experts at Erasmus University Medical Center in Rotterdam, the Netherlands.

THE SOURCE: European Heart Journal, press release, October 13, 2021

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