title: Pregnancy complications in singleton pregnancies with isolated fetal heart defects.
abstract: BACKGROUND
  As the prenatal detection rates of congenital heart defects (CHDs) increase, obstetricians are more frequently faced with pregnancies complicated by a fetal CHD. Congenital anomalies in general are associated with preterm birth and fetal demise. The aim of this study was to gain insight into the prevalence of preterm birth and fetal demise in singleton pregnancies with fetuses with isolated CHDs.
  
  
  METHODS
  A geographical cohort study was performed in a large region in the Netherlands. Fetuses and infants from singleton pregnancies diagnosed with severe isolated CHD, born between 1 January 2002 and 1 January 2012, were included. All cases in the CHD cohort were assessed for preterm birth or fetal demise. The proportions of preterm birth and fetal demise were compared with those in a control group and odds ratios were calculated.
  
  
  RESULTS
  The proportion of preterm births in the CHD cohort (n = 1013) was 9.1% (95% CI 7.3-10.9) compared with 5.6% (95% CI 5.4-5.8) in the control group, with an odds ratio of 1.7 (95% CI 1.4-2.1). The preterm birth started spontaneously in 49.5% and 38.4% were induced. In 15 cases fetal demise occurred (1.5%; 95% CI 0.8-2.2), compared with 0.7% (95% CI 0.6-0.8) in the control group, odds ratio 2.0 (95% CI 1.2-3.4).
  
  
  CONCLUSIONS
  Higher rates of preterm birth and fetal demise occur in fetuses with isolated CHD compared with the general population. Prenatal specialists should be vigilant for signs of heart failure, premature closure of the foramen ovale or fetal distress in fetuses with isolated CHDs.
authors: Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands. c.vanvelzen@vumc.nl.
authors: Christine L
authors: CL
authors: van Velzen
authors: Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.
authors: Freya
authors: http://orcid.org/0000-0002-7706-6839
authors: F
authors: Türkeri
authors: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands.
authors: Eva
authors: E
authors: Pajkrt
authors: Department of Pediatric Cardiology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands.
authors: Sally-Ann
authors: http://orcid.org/0000-0001-5276-1475
authors: SA
authors: Clur
authors: Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
authors: Marry E B
authors: http://orcid.org/0000-0001-7653-3952
authors: ME
authors: Rijlaarsdam
authors: Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.
authors: Caroline J
authors: CJ
authors: Bax
authors: Department of Pediatric Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
authors: Jaroslav
authors: http://orcid.org/0000-0002-0350-279X
authors: J
authors: Hruda
authors: Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.
authors: Christianne J M
authors: CJ
authors: de Groot
authors: Department of Pediatric Cardiology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands.|Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
authors: Nico A
authors: http://orcid.org/0000-0002-4823-6974
authors: NA
authors: Blom
authors: Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.
authors: Monique C
authors: MC
authors: Haak
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D009426:Netherlands; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology*; D011296:Prenatal Diagnosis; D015995:Prevalence; D012307:Risk Factors
keywords: Congenital heart defects; fetal demise; fetus; prenatal diagnosis; preterm birth