2013-05-26T09:01:30Z http://repub.eur.nl/oai

oai:repub.eur.nl/res/pub/27764 2012-11-14T12:29:58Z org:9834 org:9794 org:9831 org:9803 org:9755 org:9746 org:9797 access:open type:article

urn:NBN:nl:ui:15-1765/27764 2012-11-14T12:29:58 mods http://hdl.handle.net/1765/27764 hdl:1765/27764 urn:NBN:nl:ui:15-1765/27764 doi:10.1093/eurheartj/ehq200 Predictors of pregnancy complications in women with congenital heart disease text article http://hdl.handle.net/1765/27764 http://dx.doi.org/10.1093/eurheartj/ehq200 text/html born digital Aims:Data regarding pregnancy outcome in women with congenital heart disease (CHD) are limited.Methods and results: In 1802 women with CHD, 1302 completed pregnancies were observed. Independent predictors of cardiac, obstetric, and neonatal complications were calculated using logistic regression. The most prevalent cardiac complications during pregnancy were arrhythmias (4.7) and heart failure (1.6). Factors independently associated with maternal cardiac complications were the presence of cyanotic heart disease (corrected/uncorrected) (P < 0.0001), the use of cardiac medication before pregnancy (P < 0.0001), and left heart obstruction (P < 0.0001). New characteristics were mechanical valve replacement (P = 0.0014), and systemic (P = 0.04) or pulmonary atrioventricular valve regurgitation related with the underlying (moderately) complex CHD (P = 0.03). A new risk score for cardiac complications is proposed. The most prevalent obstetric complications were hypertensive complications (12.2). No correlation of maternal characteristics with adverse obstetric outcome was found. The most prevalent neonatal complications were premature birth (12), small for gestational age (14), and mortality (4). Cyanotic heart disease (corrected/uncorrected) (P = 0.0003), mechanical valve replacement (P = 0.03), maternal smoking (P = 0.007), multiple gestation (P = 0.0014), and the use of cardiac medication (P = 0.0009) correlated with adverse neonatal outcome.Conclusion: In our tertiary CHD cohort, cardiac, obstetric, and neonatal complications were frequently encountered, and (new) correlations of maternal baseline data with adverse outcome are reported. A new risk score for adverse cardiac complications is proposed, although prospective validation remains necessary. Drenthen, W. Drenthen Willem aut Boersma, H. Boersma Eric aut Balci, A. Balci Ali aut Moons, P. Moons Philip aut Roos-Hesselink, J.W. Roos-Hesselink Jolien aut Mulder, B.J.M. Mulder Barbara aut Vliegen, H.W. Vliegen Hubert aut Dijk, A.P.J. van Dijk, van Arie aut Voors, A.A. Voors Adriaan aut Yap, S-C. Yap Sing-Chien aut Veldhuisen, D.J. van Veldhuisen, van Dirk aut Pieper, P.G. Pieper Petronella aut 298686031 264424514 Erasmus MC: University Medical Center Rotterdam Supporting host sht en English European Heart Journal 0195-668X 31 17 2124 2132 2010-09-01 Pregnancy Complications Congenital heart disease Erasmus University Rotterdam oai:repub.eur.nl/res/pub/27764 IR OAIPMH feed (http://repub.eur.nl/oai) 2011-11-22T13:28:52Z 2011-11-25T13:36:25Z http://purl.org/eprint/accessRights/OpenAccess