期刊
EUROPEAN HEART JOURNAL
卷 40, 期 47, 页码 3848-3855出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehz136
关键词
Pregnancy; Maternal mortality; Congenital Heart Disease; Cardiomyopathies; Pregnancy complications
资金
- Zabawas Foundation
- De Hoop Foundation
- EORP
- Abbott Vascular Int.
- Amgen Cardiovascular
- AstraZeneca
- Bayer AG
- Boehringer Ingelheim
- Boston Scientific
- The Bristol Myers Squibb and Pfizer Alliance
- Daiichi Sankyo Europe GmbH
- Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company
- Edwards
- Gedeon Richter Plc.
- Menarini Int. Op.
- MSD-Merck Co.
- Novartis Pharma AG
- ResMed
- Sanofi
- SERVIER
Aims Reducing maternal mortality is a World Health Organization (WHO) global health goal. Although maternal deaths due to haemorrhage and infection are declining, those related to heart disease are increasing and are now the most important cause in western countries. The aim is to define contemporary diagnosis-specific outcomes in pregnant women with heart disease. Methods and results From 2007 to 2018, pregnant women with heart disease were prospectively enrolled in the Registry Of Pregnancy And Cardiac disease (ROPAC). Primary outcome was maternal mortality or heart failure, secondary outcomes were other cardiac, obstetric, and foetal complications. We enrolled 5739 pregnancies; the mean age was 29.5. Prevalent diagnoses were congenital (57%) and valvular heart disease (29%). Mortality (overall 0.6%) was highest in the pulmonary arterial hypertension (PAH) group (9%). Heart failure occurred in 11%, arrhythmias in 2%. Delivery was by Caesarean section in 44%. Obstetric and foetal complications occurred in 17% and 21%, respectively. The number of high-risk pregnancies (mWHO Class IV) increased from 0.7% in 2007-2010 to 10.9% in 2015-2018. Determinants for maternal complications were pre-pregnancy heart failure or New York Heart Association >II, systemic ejection fraction <40%, mWHO Class 4, and anticoagulants use. After an increase from 2007 to 2009, complication rates fell from 13.2% in 2010 to 9.3% in 2017. Conclusion Rates of maternal mortality or heart failure were high in women with heart disease. However, from 2010, these rates declined despite the inclusion of more high-risk pregnancies. Highest complication rates occurred in women with PAH.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据