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. 2014 Jun 26;3(3):e000953.
doi: 10.1161/JAHA.114.000953.

Heart valve prostheses in pregnancy: outcomes for women and their infants

Claire M Lawley  1 , Charles S Algert  2 , Jane B Ford  2 , Tanya A Nippita  3 , Gemma A Figtree  4 , Christine L Roberts  2
Affiliations

Heart valve prostheses in pregnancy: outcomes for women and their infants

Claire M Lawley et al. J Am Heart Assoc. .

Erratum in

  • J Am Heart Assoc. 2014 Aug;3(4):e000414

Abstract

Background: As the prognosis of women with prosthetic heart valves improves, an increasing number are contemplating and undertaking pregnancy. Accurate knowledge of perinatal outcomes is essential, assisting counseling and guiding care. The aims of this study were to assess outcomes in a contemporary population of women with heart valve prostheses undertaking pregnancy and to compare outcomes for women with mechanical and bioprosthetic prostheses.

Methods and results: Longitudinally linked population health data sets containing birth and hospital admissions data were obtained for all women giving birth in New South Wales, Australia, 2000-2011. This included information identifying presence of maternal prosthetic heart valve. Cardiovascular and birth outcomes were evaluated. Among 1 144 156 pregnancies, 136 involved women with a heart valve prosthesis (1 per 10 000). No maternal mortality was seen among these women, although the relative risk for an adverse event was higher than the general population, including severe maternal morbidity (139 versus 14 per 1000 births, rate ratio [RR]=9.96, 95% CI 6.32 to 15.7), major maternal cardiovascular event (44 versus 1 per 1000, RR 34.6, 95% CI 14.6 to 81.6), preterm birth (183 versus 66 per 1000, RR=2.77, 95% CI 1.88 to 4.07), and small-for-gestational-age infants (193 versus 95 per 1000, RR=2.03, 95% CI 1.40 to 2.96). There was a trend toward increased maternal and perinatal morbidity in women with a mechanical valve compared with those with a bioprosthetic valve.

Conclusions: Pregnancies in women with a prosthetic heart valve demonstrate an increased risk of an adverse outcome, for both mothers and infants, compared with pregnancies in the absence of heart valve prostheses. In this contemporary population, the risk was lower than previously reported.

Keywords: cardiovascular diseases; heart valve prosthesis; infant; perinatal mortality; pregnancy.

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References

    1. Fernandes SM, Pearson DD, Rzeszut A, Mitchell SJ, Landzberg MJ, Martin GRAmerican College of Cardiology ACHDWG, Adult Congenital Cardiac Care Associate Research N. Adult congenital heart disease incidence and consultation: a survey of general adult cardiologists. J Am Coll Cardiol. 2013; 61:1303-1304. - PubMed
    1. Marelli AJ, Mackie AS, Ionescu‐Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007; 115:163-172. - PubMed
    1. Khairy P, Ionescu‐Ittu R, Mackie AS, Abrahamowicz M, Pilote L, Marelli AJ. Changing mortality in congenital heart disease. J Am Coll Cardiol. 2010; 56:1149-1157. - PubMed
    1. Ruel M, Kulik A, Lam BK, Rubens FD, Hendry PJ, Masters RG, Bedard P, Mesana TG. Long‐term outcomes of valve replacement with modern prostheses in young adults. Eur J Cardiothorac Surg. 2005; 27:425-433. - PubMed
    1. Hui C, Lili M, Libin C, Rui Z, Fang G, Ling G, Jianping Z. Changes in coagulation and hemodynamics during pregnancy: a prospective longitudinal study of 58 cases. Arch Gynecol Obstet. 2012; 285:1231-1236. - PubMed

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