title: Cardiac function and cardiac events 1-year postpartum in women with congenital heart disease.
abstract: BACKGROUND
  Pregnancy is increasingly common in women with congenital heart disease (CHD), but little is known about long-term cardiovascular outcome after pregnancy in these patients. We studied the incidence of cardiovascular events 1-year postpartum and compared cardiac function prepregnancy and 1-year postpartum in women with CHD.
  
  
  METHODS
  From our national, prospective multicenter cohort study, 172 women were studied. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement were performed during pregnancy and 12 months postpartum. Cardiovascular events were defined as need for an urgent invasive cardiovascular procedure, heart failure, arrhythmia, thromboembolic events, myocardial infarction, cardiac arrest, cardiac death, endocarditis, and aortic dissection.
  
  
  RESULTS
  Cardiovascular events were observed after 11 pregnancies (6.4%). Women with cardiovascular events postpartum had significant higher NT-proBNP values at 20-week gestation (191 [137-288] vs 102.5 [57-167]; P = .049) and 1-year postpartum compared with women without cardiovascular events postpartum (306 [129-592] vs 105 [54-187] pg/mL; P = .014). Women with cardiovascular events during pregnancy were at higher risk for late cardiovascular events (HR 7.1; 95% CI 2.0-25.3; P = .003). In women with cardiovascular events during pregnancy, subpulmonary end-diastolic diameter had significantly increased 1-year postpartum (39.0 [36.0-48.0] to 44.0 [40.0-50.0]; P = .028). No other significant differences were found in cardiac function or size 1-year postpartum compared with preconception values.
  
  
  CONCLUSIONS
  Cardiovascular events are relatively rare 1 year after pregnancy in women with CHD. Women with cardiovascular events during pregnancy are prone to develop cardiovascular events 1-year postpartum and have increased subpulmonary ventricular diameter compared with preconception values.
authors: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; The Netherlands Heart Institute (ICIN), Utrecht, the Netherlands.
authors: Marlies A M
authors: MA
authors: Kampman
authors: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Cardiology, Isala, Zwolle, the Netherlands.
authors: Ali
authors: A
authors: Balci
authors: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors: Henk
authors: H
authors: Groen
authors: Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: Arie P J
authors: AP
authors: van Dijk
authors: Department of Cardiology, Erasmus Medical Center, University of Rotterdam, Rotterdam, the Netherlands.
authors: Jolien W
authors: JW
authors: Roos-Hesselink
authors: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors: Joost P
authors: JP
authors: van Melle
authors: Department of Gynaecology and Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors: Krystyna M
authors: KM
authors: Sollie-Szarynska
authors: Department of Cardiology, Medical Spectrum Twente, Enschede, the Netherlands.
authors: Elly M C J
authors: EM
authors: Wajon
authors: Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Barbara J M
authors: BJ
authors: Mulder
authors: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors: Dirk J
authors: DJ
authors: van Veldhuisen
authors: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: p.g.pieper@umcg.nl.
authors: Petronella G
authors: PG
authors: Pieper
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D020097:Natriuretic Peptide, Brain; D009426:Netherlands / Q000453:epidemiology; D010446:Peptide Fragments; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain