Diuretics in Pregnancy: Data from the ESC Registry of Pregnancy and Cardiac Disease (ROPAC)
Authors' conclusion
Our study does not conclusively establish an association between diuretic use during pregnancy and adverse foetal outcomes.
Study context
- Population
- Pregnancies in women with heart disease (ESC ROPAC registry)
- Participants
- 5,739 ROPAC pregnancies
- Exposure
- Diuretic use during pregnancy vs no diuretic use
- Diureticsn = 382
- Outcome
- Perinatal outcomes after in-utero diuretic exposure: congenital anomalies and foetal growth
Methodological detailsglobal registry, multivariable regression
- Global registry
- Multivariable regression
Main finding
As reported in the abstract
Diuretics vs No diureticsOdds ratio (95% CI)
Foetal or neonatal congenital anomalies; first-trimester use
1.3(0.7–2.6)
Small for gestational age
1.4(1.0–1.9)
Observational data: associations, not effects.
Further findings
Factors associated with diuretic use during pregnancy
- Age >35 years, OR
- 1.5 (1.2-2.0) (95% CI)
- Other cardiac medication use, OR
- 5.4 (4.2-6.9) (95% CI)
- Signs of HF, OR
- 1.7 (1.2-2.2) (95% CI)
- Estimated LVEF <40%, OR
- 2.9 (2.0-4.2) (95% CI)
- NYHA class >II, OR
- 3.4 (2.3-5.1) (95% CI)
- Valvular heart disease, OR
- 6.3 (4.7-8.3) (95% CI)
- Cardiomyopathy, OR
- 3.9 (2.6-5.7) (95% CI)
Original publication
Diuretics in Pregnancy: Data from the ESC Registry of Pregnancy and Cardiac Disease (ROPAC). Eur J Heart Fail. Published 4 June 2024. doi:10.
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