Adverse fetal/neonatal and obstetric outcomes in pregnancies with both maternal and fetal heart disease

J Perinatol. 2024 Oct;44(10):1424-1431. doi: 10.1038/s41372-024-02058-3. Epub 2024 Jul 23.

Abstract

Objective: To investigate fetal/neonatal and obstetric events in pregnancies with both maternal and fetal heart disease.

Study design: From the CARPREG database, singleton pregnancies (>24 weeks) in patients with structural heart disease that underwent fetal/neonatal echocardiograms were selected and separated in two groups: maternal heart disease only (M-HD) and maternal and fetal heart disease (MF-HD). Differences in adverse fetal/neonatal (death, preterm birth, and small for gestational age) and obstetric (preeclampsia/eclampsia) outcomes between groups were analyzed.

Results: From 1011 pregnancies, 93 had MF-HD. Fetal/neonatal events (38.7% vs 25.3%, p = 0.006) and spontaneous preterm birth (10.8% vs 4.9%, p = 0.021) were more frequent in MF-HD compared to M-HD, with no difference in obstetric events. MF-HD remained as a significant predictor of fetal/neonatal events after adjustment (OR:1.883; 95% CI:1.182-3.000; p = 0.008).

Conclusions: Pregnancies with MF-HD are at risk of adverse fetal/neonatal events and spontaneous preterm birth. Larger studies are needed to determine their association with preeclampsia.

MeSH terms

  • Adult
  • Echocardiography
  • Female
  • Fetal Diseases / epidemiology
  • Gestational Age
  • Heart Diseases
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Logistic Models
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology
  • Pregnancy Outcome*
  • Premature Birth* / epidemiology
  • Retrospective Studies
  • Ultrasonography, Prenatal