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Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology

Roos-Hesselink, Jolien W. ; Ruys, Titia P. E. ; Stein, Joerg I. ; Thilén, Ulf LU ; Webb, Gary D. ; Niwa, Koichiro ; Kaemmerer, Harald ; Baumgartner, Helmut ; Budts, Werner and Maggioni, Aldo P. , et al. (2013) In European Heart Journal 34(9). p.657-665
Abstract
Aims To describe the outcome of pregnancy in patients with structural or ischaemic heart disease. Methods and results In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and... (More)
Aims To describe the outcome of pregnancy in patients with structural or ischaemic heart disease. Methods and results In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and IHD in 2%. Maternal death occurred in 1%, compared with 0.007% in the normal population. Highest maternal mortality was found in patients with CMP. During pregnancy, 338 patients (26%) were hospitalized, 133 for heart failure. Caesarean section was performed in 41%. Foetal mortality occurred in 1.7% and neonatal mortality in 0.6%, both higher than in the normal population. Median duration of pregnancy was 38 weeks (range 24-42) and median birth weight 3010 g (range 300-4850). In centres of developing countries, maternal and foetal mortality was higher than in centres of developed countries (3.9 vs. 0.6%, P < 0.001 and 6.5 vs. 0.9% P < 0.001) Conclusion The vast majority of patients can go safely through pregnancy and delivery as long as adequate pre-pregnancy evaluation and specialized high-quality care during pregnancy and delivery are available. Pregnancy outcomes were markedly worse in patients with CMP and in developing countries. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Pregnancy, Congenital heart disease, Valvular heart disease, Cardiomyopathy, Ischaemic heart disease
in
European Heart Journal
volume
34
issue
9
pages
657 - 665
publisher
Oxford University Press
external identifiers
  • wos:000316056300011
  • scopus:84874704808
  • pmid:22968232
ISSN
1522-9645
DOI
10.1093/eurheartj/ehs270
language
English
LU publication?
yes
id
45388350-4075-44fd-849b-02bdc6d662f9 (old id 3657187)
date added to LUP
2016-04-01 14:27:40
date last changed
2022-04-14 17:55:29
@article{45388350-4075-44fd-849b-02bdc6d662f9,
  abstract     = {{Aims To describe the outcome of pregnancy in patients with structural or ischaemic heart disease. Methods and results In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and IHD in 2%. Maternal death occurred in 1%, compared with 0.007% in the normal population. Highest maternal mortality was found in patients with CMP. During pregnancy, 338 patients (26%) were hospitalized, 133 for heart failure. Caesarean section was performed in 41%. Foetal mortality occurred in 1.7% and neonatal mortality in 0.6%, both higher than in the normal population. Median duration of pregnancy was 38 weeks (range 24-42) and median birth weight 3010 g (range 300-4850). In centres of developing countries, maternal and foetal mortality was higher than in centres of developed countries (3.9 vs. 0.6%, P &lt; 0.001 and 6.5 vs. 0.9% P &lt; 0.001) Conclusion The vast majority of patients can go safely through pregnancy and delivery as long as adequate pre-pregnancy evaluation and specialized high-quality care during pregnancy and delivery are available. Pregnancy outcomes were markedly worse in patients with CMP and in developing countries.}},
  author       = {{Roos-Hesselink, Jolien W. and Ruys, Titia P. E. and Stein, Joerg I. and Thilén, Ulf and Webb, Gary D. and Niwa, Koichiro and Kaemmerer, Harald and Baumgartner, Helmut and Budts, Werner and Maggioni, Aldo P. and Tavazzi, Luigi and Taha, Nasser and Johnson, Mark R. and Hall, Roger}},
  issn         = {{1522-9645}},
  keywords     = {{Pregnancy; Congenital heart disease; Valvular heart disease; Cardiomyopathy; Ischaemic heart disease}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{657--665}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal}},
  title        = {{Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology}},
  url          = {{http://dx.doi.org/10.1093/eurheartj/ehs270}},
  doi          = {{10.1093/eurheartj/ehs270}},
  volume       = {{34}},
  year         = {{2013}},
}