title: Maternal congenital cardiac disease: outcomes of pregnancy in a single tertiary care center.
abstract: OBJECTIVE
  To evaluate contemporary perinatal and cardiac outcomes of pregnancies in women with major structural congenital heart disease.
  
  
  METHODS
  Obstetric, neonatal, and cardiac outcomes were abstracted retrospectively from medical records of all women with congenital cardiac disease delivering at our institution from 2000-2007 and compared by type of structural defect. Predictors of adverse cardiac or obstetric events were identified.
  
  
  RESULTS
  Over the 7-year study period, 74 deliveries occurred in 69 women with congenital heart disease, median age 28 years. There were three right-obstructive defects, 14 left-obstructive defects, four right-regurgitant defects, 19 conotruncal defects, 19 shunts, and four miscellaneous lesions. There were 21 adverse cardiac events in 15 pregnancies (20.2%); these were defined as maternal death, congestive heart failure, myocardial infarction, stroke, the need for urgent cardiac intervention, or arrhythmia requiring treatment. There were 44 adverse obstetric events in 34 pregnancies (45.9%), defined as preterm delivery, stillbirth, preeclampsia, small for gestational age, or neonatal intensive care unit admission. Patients with shunt morphology were more likely to experience adverse obstetric and cardiac outcomes.
  
  
  CONCLUSIONS
  Pregnancy in women with underlying major congenital heart defects poses increased risks to both mother and fetus. Nonetheless, favorable maternal and neonatal outcomes occur in the majority of patients.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 10032, USA. aaf2013@columbia.edu
authors.forename: Abigail A
authors.initials: AA
authors.lastname: Ford
authors.forename: Blair J
authors.initials: BJ
authors.lastname: Wylie
authors.forename: Carol A
authors.initials: CA
authors.lastname: Waksmonski
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Simpson
mesh_terms: D001724:Birth Weight; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology