Risk of Stillbirth and Preterm Birth in Cardiac Arrhythmias During Pregnancy
Authors' conclusion
The overall prevalence of cardiac tachyarrhythmias in pregnant women was low (0.2%) but has significantly increased in recent years. Compared with those without tachyarrhythmias, VA was significantly associated with higher odds of stillbirth, whereas SVT and AF were not. All tachyarrhythmia subtypes were associated with higher odds of preterm birth. Cardioversion/defibrillation might not be associated with higher odds of stillbirth and preterm birth.
Study context
- Population
- Pregnant women with cardiac tachyarrhythmias (AF, VA, SVT) and those without, identified through ICD-10-CM codes (2017–2020)pregnant women, 11,091 (0.2%) had cardiac tachyarrhythmias
- Participants
- 7,517,975 women
- Exposure
- Risk of stillbirth and preterm birth between pregnant women with cardiac arrhythmias and those without
- VAn = 906
- AFn = 2,340
- SVTn = 7,503
- Outcome
- Prevalence of cardiac arrhythmias over time
- Follow-up
- 2017-2020
Methodological detailsPropensity score matching, multivariate analysis
- Propensity score matching
- Multivariate analysis
Main finding
As reported in the abstract
- The prevalence of cardiac arrhythmias, including SVT and VA subtypes, increased significantly during the study period
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| StillbirthVAvs without arrhythmiasMultivariate analysis | 3.83 (1.21–12.12) | P = 0.02 | |
| StillbirthSVTvs without arrhythmiasMultivariate analysis | 1.32 (0.77–2.28) | P = 0.32 | |
| StillbirthAFvs without arrhythmiasMultivariate analysis | 1.15 (0.51–2.59) | P = 0.74 | |
| Preterm birthVAvs without arrhythmias | 2.01 (1.56–2.60) | P < 0.01 | |
| Preterm birthAFvs without arrhythmias | 1.63 (1.38–1.93) | P < 0.01 | |
| Preterm birthSVTvs without arrhythmias | 1.19 (1.07–1.32) | P < 0.01 | |
| Stillbirth and preterm birth with cardioversion/defibrillation among patients with tachyarrhythmiasUnderwent cardioversion/defibrillationvs did not undergo these proceduresStillbirth | 2.62 (0.10–66.95) | P = 0.56 | |
| Stillbirth and preterm birth with cardioversion/defibrillation among patients with tachyarrhythmiasUnderwent cardioversion/defibrillationvs did not undergo these proceduresPreterm birth | 1.82 (0.98–3.40) | P = 0.06 | |
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | VA | AF | SVT |
|---|---|---|---|
| Cardioversion/defibrillationSVT and AF: cardioversion; VA: defibrillation | 1.9% | 2.6% | 0.5% |
Stillbirth incidence trend
- Nonsignificant upward trend in stillbirth incidence among patients with tachyarrhythmias
- Nonsignificant downward trend in those without tachyarrhythmias
Original publication
Risk of Stillbirth and Preterm Birth in Cardiac Arrhythmias During Pregnancy. JACC Clin Electrophysiol. Published 14 May 2025. doi:10.
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