title: Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology.
abstract: OBJECTIVE
  To describe the outcome of pregnancy in patients with structural or ischaemic heart disease.
  
  
  RESULTS
  In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and IHD in 2%. Maternal death occurred in 1%, compared with 0.007% in the normal population. Highest maternal mortality was found in patients with CMP. During pregnancy, 338 patients (26%) were hospitalized, 133 for heart failure. Caesarean section was performed in 41%. Foetal mortality occurred in 1.7% and neonatal mortality in 0.6%, both higher than in the normal population. Median duration of pregnancy was 38 weeks (range 24-42) and median birth weight 3010 g (range 300-4850). In centres of developing countries, maternal and foetal mortality was higher than in centres of developed countries (3.9 vs. 0.6%, P < 0.001 and 6.5 vs. 0.9% P < 0.001)
  
  
  CONCLUSIONS
  The vast majority of patients can go safely through pregnancy and delivery as long as adequate pre-pregnancy evaluation and specialized high-quality care during pregnancy and delivery are available. Pregnancy outcomes were markedly worse in patients with CMP and in developing countries.
authors.affiliation: Department of Cardiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. j.roos@erasmusmc.nl
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.forename: Titia P E
authors.initials: TP
authors.lastname: Ruys
authors.forename: Jörg I
authors.initials: JI
authors.lastname: Stein
authors.forename: Ulf
authors.initials: U
authors.lastname: Thilén
authors.forename: Gary D
authors.initials: GD
authors.lastname: Webb
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
authors.forename: Harald
authors.initials: H
authors.lastname: Kaemmerer
authors.forename: Helmut
authors.initials: H
authors.lastname: Baumgartner
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
authors.forename: Aldo P
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.forename: Nasser
authors.initials: N
authors.lastname: Taha
authors.forename: Mark R
authors.initials: MR
authors.lastname: Johnson
authors.forename: Roger
authors.initials: R
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000453:epidemiology* / Q000401:mortality; D002585:Cesarean Section / Q000706:statistics & numerical data; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000401:mortality; D006349:Heart Valve Diseases / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000401:mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000401:mortality; D011256:Pregnancy Outcome / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult