Maternal arrhythmia and perinatal outcomes.
The objective of this study was to determine whether arrhythmia in the setting of maternal cardiac disease (MCD) affects perinatal outcomes.



This is a retrospective cohort study of pregnant women with MCD who delivered during 2008 to 2013. Perinatal outcomes among women with an arrhythmia were compared with those without.



Among 143 women, 36 (25%) had an arrhythmia. Those with an arrhythmia were more likely to have a spontaneous vaginal delivery (64 vs 43%, P<0.05) and required fewer operative vaginal births (8 vs 27%, P=0.02). Pregnancies were more likely to be complicated by intrauterine growth restriction (IUGR) (17 vs 5%, P<0.05), although there were no differences in the rate of small for gestational age. The risk of IUGR remained increased after controlling for confounding (adjusted odds ratio 6.98, 95% confidence interval 1.59 to 30.79, P=0.01). Two cases of placental abruption were identified among mothers with arrhythmia while none were identified in the controls (P<0.05).



Patients with arrhythmias were more likely to have a spontaneous vaginal delivery. Our data suggest that these pregnancies were an increased risk for IUGR.
Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, CA, USA.
D
D
Henry
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
J M
JM
Gonzalez
Department of Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
I S
IS
Harris
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
T N
TN
Sparks
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
M
M
Killion
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
M-P
MP
Thiet
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
K
K
Bianco
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult