title: Frequency of Miscarriage/Stillbirth and Terminations of Pregnancy Among Women With Congenital Heart Disease in Germany, Hungary and Japan.
abstract: BACKGROUND
  The 2011 guidelines of the European Society of Cardiology (ESC) on the management of cardiovascular diseases during pregnancy define the maternal predictors for neonatal complications. The aim of this study was to determine whether these are associated with an increased number of miscarriages/stillbirths and terminations of pregnancy (TOPs) also in patients with congenital heart defects (CHD).
  
  
  RESULTS
  The 634 women from Germany, Hungary and Japan were surveyed concerning the issues of sexuality and reproductive health, as well as their general life situation and medical care. 25% of the recorded pregnancies in women with CHD resulted in miscarriage, stillbirth or TOP. Affecting 16.8% of all recorded pregnancies, miscarriages or stillbirths occurred more frequently than in the general population and more than previously recorded for patients with CHD. TOP occurred in 8% of the surveyed pregnancies. Underlying maternal predictors for neonatal events had an influence on the number of TOP; among those with underlying predictors, TOP was recorded 3-fold more than in those without such predictors (15.6% vs. 5.5%). Remarkably, a significant deficit regarding the level of information on potential pregnancy-associated risks was observed in all 3 participating countries.
  
  
  CONCLUSIONS
  Pregnant women with CHD should always be treated and counseled individually by cardiologists, gynecologists, obstetricians and anesthetists with appropriate expert knowledge. (Circ J 2016; 80: 1846-1851).
authors.affiliation: German Heart Centre Munich, Department of Paediatric Cardiology and Congenital Heart Defects, Technical University of Munich.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Koerten
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
authors.forename: András
authors.initials: A
authors.lastname: Szatmári
authors.forename: Balint
authors.initials: B
authors.lastname: Hajnalka
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Ruzsa
authors.forename: Nicole
authors.initials: N
authors.lastname: Nagdyman
authors.forename: Eva
authors.initials: E
authors.lastname: Niggemeyer
authors.forename: Brigitte
authors.initials: B
authors.lastname: Peters
authors.forename: Karl-Theodor M
authors.initials: KT
authors.lastname: Schneider
authors.forename: Bettina
authors.initials: B
authors.lastname: Kuschel
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
authors.forename: Harald
authors.initials: H
authors.lastname: Kaemmerer
authors.forename: Ulrike M M
authors.initials: UM
authors.lastname: Bauer
mesh_terms: D000028:Abortion, Induced; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D005260:Female; D005858:Germany / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D050497:Stillbirth / Q000453:epidemiology*