Effect of maternal congenital heart defects on labor and delivery outcome: A population-based study

Abstract

Objective. The primary objective of this study was to characterize the delivery outcome of parturients with congenital heart defects (CHD), from maternal and from neonatal perspectives.

Study design. A retrospective population-based study was conducted, covering a 13-year period (1989–2002) with an aggregate of 151 487 deliveries of all women with and without CHD. Maternal demographics, obstetrical and medical history, delivery outcome, and neonatal outcome were drawn from a computerized perinatal database.

Results. Sixty-seven women with CHD had 156 deliveries. The severity of CHD, based on the New York Heart Association (NYHA) classification, was I or II in 99.1% of the deliveries. CHD patients had significantly higher rates of labor induction and neonatal malformations. Maternal CHD was discovered as an independent risk factor associated with neonatal malformations (OR 2.10, 95% CI 1.18–3.72). No significant differences were noted between women with CHD and the controls regarding maternal morbidities and Apgar scores.

Conclusions. The labor outcome of CHD patients with NYHA classification I and II resembles that of non-CHD women in a tertiary center setting. Neonates of CHD mothers have higher rates of congenital malformations even among asymptomatic or mildly symptomatic mothers. A careful sonographic follow-up is warranted among all pregnancies of CHD patients.

Keywords:

• Congenital heart disease
• high risk pregnancy
• maternal heart disease
• neonatal outcome
• neonatal malformations