Cardio-oncology & otherCohort study
Diuretics in Pregnancy: Data from the ESC Registry of Pregnancy and Cardiac Disease (ROPAC)
- Prospective registry cohort study
- global registry
- multivariable regression
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
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:10.1002/ejhf.3301
Summarised from the published abstract; every number is checked against it