Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis
Authors' conclusion
This population-based study illustrates a reassuringly low maternal mortality rate in a highly developed healthcare system. Nevertheless, maternal morbidity and neonatal morbidity/mortality were significantly increased in women with ACHD and their offspring compared to non-ACHD controls
Study context
- Population
- Pregnancies in women with congenital heart disease (CHD), German health insurance (BARMER GEK) data, 2005–20187,512 vs 11,225 pregnancies
- Participants
- 4,015 vs 6,502
- Exposure
- Pregnancies in women with CHD vs age-matched non-CHD controls
- CHDn = 4,015
- Controln = 6,502reference
- Outcome
- Maternal and neonatal complications and outcome
Methodological detailsnationwide, age-matched control group, administrative health insurance data
- Nationwide
- Age-matched control group
- Administrative health insurance data
Main finding
As reported in the abstract
Maternal and neonatal complications
Higher rate of stroke, HF and cardiac arrhythmias during pregnancy with CHD
P < 0.001 for all
Observational data: associations, not effects.
Further findings
Caesarean delivery
P < 0.001
Neonatal mortality
P = 0.001
| Outcome | Times higher | P value |
|---|---|---|
| Recurrence of CHD in infants | 6.1 | P < 0.0001 |
Neonatal morbidity
- Low/extremely low birth weight or extreme immaturity more often in offspring of CHD mothers
- <0.001
- Resuscitation and mechanical ventilation more often in offspring of CHD mothers
- P < 0.001 for both
Predictors of adverse neonatal outcome (multivariate logistic regression)
- Maternal defect complexity, arterial hypertension, HF, prior fertility treatment and VKA anticoagulation were significant predictors
- P < 0.05 for all
Original publication
Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis. Eur Heart J. Published 12 October 2021. doi:10.
Summarised from the published abstract; every number is checked against it