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


METHODS
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.
Sidlik
Rakefet
R
Department of Obstetrics & Gynecology, Faculty of Health Services, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sheiner
Eyal
E
Levy
Amalia
A
Wiznitzer
Arnon
A
D000328:Adult; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies