Journal
CIRCULATION JOURNAL
Volume 80, Issue 8, Pages 1846-1851Publisher
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-15-1296
Keywords
Adult congenital heart disease; Miscarriage; Neonatal complications; Pregnancy; Stillbirth
Categories
Funding
- Competence Network for Congenital Heart Defects
- Federal Ministry of Education and Research [01GI0601]
- DZHK (German Centre for Cardiovascular Research)
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Background: The 2011 guidelines of the European Society of Cardiology (ESC) on the management of cardiovascular diseases during pregnancy define the maternal predictors for neonatal complications. The aim of this study was to determine whether these are associated with an increased number of miscarriages/stillbirths and terminations of pregnancy (TOPs) also in patients with congenital heart defects (CHD). Methods and Results: The 634 women from Germany, Hungary and Japan were surveyed concerning the issues of sexuality and reproductive health, as well as their general life situation and medical care. 25% of the recorded pregnancies in women with CHD resulted in miscarriage, stillbirth or TOP. Affecting 16.8% of all recorded pregnancies, miscarriages or stillbirths occurred more frequently than in the general population and more than previously recorded for patients with CHD. TOP occurred in 8% of the surveyed pregnancies. Underlying maternal predictors for neonatal events had an influence on the number of TOP; among those with underlying predictors, TOP was recorded 3-fold more than in those without such predictors (15.6% vs. 5.5%). Remarkably, a significant deficit regarding the level of information on potential pregnancy-associated risks was observed in all 3 participating countries. Conclusions: Pregnant women with CHD should always be treated and counseled individually by cardiologists, gynecologists, obstetricians and anesthetists with appropriate expert knowledge.
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