Maternal and neonatal outcomes in women with congenital heart disease: A nationwide population-based study

Kuan-Miao Lin; Yun-Hsuan Yang; Chuan-Pin Lee; Ko-Jung Chen; Yao-Hsu Yang; Jiunn-Ming Sheen; Shao-Ju Chien

doi:10.1016/j.jfma.2023.11.009

Maternal and neonatal outcomes in women with congenital heart disease: A nationwide population-based study

J Formos Med Assoc. 2024 Mar 13:S0929-6646(23)00475-8. doi: 10.1016/j.jfma.2023.11.009. Online ahead of print.

Authors

Kuan-Miao Lin¹, Yun-Hsuan Yang¹, Chuan-Pin Lee², Ko-Jung Chen², Yao-Hsu Yang³, Jiunn-Ming Sheen⁴, Shao-Ju Chien⁵

Affiliations

¹ Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
² Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan.
³ Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
⁴ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan. Electronic address: ray.sheen@gmail.com.
⁵ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: csjdc@cgmh.org.tw.

PMID: 38485554
DOI: 10.1016/j.jfma.2023.11.009

Abstract

Background: We evaluated the outcomes of pregnancy in women with congenital heart disease (CHD) and their offspring in Taiwan. We also investigated how different severity levels may influence the outcomes.

Methods: We used data (2009-2017) from the Birth Certificate Application database in Taiwan, which is linked to the National Health Insurance Research Database and Taiwan Maternal and Child Health Database. We identified 2990 women with CHD who had 4227 births. Based on the CHD subtypes, patients were further divided into "severe CHD" and "simple CHD" groups.

Results: Women with CHD have a significant risk of stillbirth. In maternal cardiac events, they had the highest risk of heart failure, followed by arrhythmia. The severity of CHD had a significant effect on the outcomes as well. The neonatal birth event that mothers with CHD have the highest risk of is preterm birth at < 32 weeks of gestation. The prominent difference in neonatal morbidities between mothers with severe and simple CHD is recurrent CHD in the offspring. The offspring of the severe CHD group had a higher risk of severe CHD, whereas those of the simple CHD group had a higher risk of simple CHD.

Conclusions: During pregnancy, the monitoring of heart function and cardiac rhythm could be more intensive in mothers with CHD. In addition to accurately assessing fetal growth and development during antenatal care, mothers with severe CHD should be provided with careful fetal heart structure assessment and genetic testing along with counseling.

Keywords: Congenital heart disease; Neonates; Outcome; Pregnancy; Women.