Congenital heart diseaseCohort study
Refining current risk stratification guidelines for pregnant women with Fontan circulation: lessons from PROFAT registry
- Retrospective cohort study
- multicentre
- registry
Authors' conclusion
Pregnancy in women with Fontan circulation poses a significant cardiovascular risk for the mother and a high burden of fetal and neonatal complications. The existing predictive risk stratification models do not discriminate hazard between well-functioning patients with Fontan from those with additional hemodynamic burden.
Study context
- Population
- Pregnant women (>20 weeks of gestation) with a Fontan circulation, 13 international centres, 2006–2018
- Participants
- 84 women · 108 pregnancies
- Outcome
- Maternal and fetal complications (risk factors) and performance of risk stratification tools (modified WHO, CARPREG II, ZAHARA)
Main finding
As reported in the abstract
Maternal CV complications
- Maternal CV complications (pregnancies)
- 32 (30%)
- Fontan circulatory failure
- 17%
- Supraventricular tachycardia
- 7.4%
- Thromboembolic events
- 3.7%
- Maternal deaths
- 0
- Pre-pregnancy oxygen saturation and adverse maternal outcomes, adjusted OR
- 0.77 (95% CI 0.61-0.96; p=0.02)
Observational data: associations, not effects.
Further findings
Fetal and neonatal outcomes
- Premature birth, share of neonatal complications
- 68%
- Fetal and neonatal mortality
- 13%
- Modified WHO classification the only risk model significantly associated with adverse fetal outcomes
Original publication
Refining current risk stratification guidelines for pregnant women with Fontan circulation: lessons from PROFAT registry. Eur J Prev Cardiol. Published 22 July 2025. doi:10.1093/eurjpc/zwaf456
Summarised from the published abstract; every number is checked against it