title: Outcomes of pregnancy complicated by heart disease at Maharaj Nakorn Chiang Mai Hospital.
abstract: OBJECTIVE
  To determine pregnancy outcomes of women complicated by heart disease.
  
  
  METHODS
  Pregnant women complicated with heart disease between January 1993 and December 2007, at Maharaj Nakorn Chiang Mai Hospital, were recruited to a retrospective cohort study. The normal controls were identified to match the cases with a ratio of 2:1. The main outcomes for comparison included fetal mortality and morbidity focusing on preterm birth and fetal growth restriction.
  
  
  RESULTS
  One hundred twenty five pregnant women with heart disease and 250 controls were recruited. Rheumatic heart disease was more common than congenital heart disease (48.8% and 44.8%). The baseline characteristics were similar between both groups. The prevalence of operative vaginal delivery was significantly higher in the study group (32.8% and 4.4%, p < 0.001) while the cesarean section rate was similar. The prevalence of fetal death, low Apgar score, preterm births, fetuses with low birth weight, and fetal growth restriction and were significantly higher in the study group with a relative risk of 6.0, 3.0, 2.2, 1.92, and 1.8, respectively.
  
  
  CONCLUSIONS
  Rheumatic heart disease is still prevalent. The fetal outcomes especially fetal death, preterm birth, intrauterine fetal growth restriction, low birth weight, and birth asphyxia were more common among pregnancies complicated by heart disease.
authors.affiliation: Department of Obstetrics & Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Thanate
authors.initials: T
authors.lastname: Jatavan
authors.forename: Suchaya
authors.initials: S
authors.lastname: Luewan
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology; D005865:Gestational Age; D006331:Heart Diseases / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D054238:Perinatal Mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult