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. 2016 Oct;36(10):823-7.
doi: 10.1038/jp.2016.90. Epub 2016 Jun 16.

Maternal arrhythmia and perinatal outcomes

D Henry  1 , J M Gonzalez  2 , I S Harris  3 , T N Sparks  2 , M Killion  2 , M-P Thiet  2 , K Bianco  4
Affiliations

Maternal arrhythmia and perinatal outcomes

D Henry et al. J Perinatol. 2016 Oct.

Abstract

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

Study design: 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.

Results: 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).

Conclusion: Patients with arrhythmias were more likely to have a spontaneous vaginal delivery. Our data suggest that these pregnancies were an increased risk for IUGR.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Distribution of diagnoses among women with arrhythmia. Afib: Atrial fibrillation, SVT: supraventricular tachycardia, VT: ventricular tachycardia, WPW: Wolf-Parkinson-White, ARVD: Arrhythmogenic Right Ventricular Dysplasia, CMP: Cardiomyopathy with arrhythmia (the + is the arrhythmia diangosis in addition to concurrent structural cardiac disease).
Figure 2
Figure 2
Mode of delivery by arrhythmia status. CD: Cesarean delivery, SVD: spontaneous vaginal delivery; OVD: operative vaginal delivery, FAVD: forceps assisted vaginal delivery, VAVD: vacuum assisted vaginal delivery. * P-value < 0.05, represents Chi-2 test for comparisons of proportions.
See this image and copyright information in PMC

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