Pregnancy in women with corrected tetralogy of Fallot: Occurrence and predictors of adverse events - 06/08/11

Doi : 10.1016/j.ahj.2010.10.027

Ali Balci, MD, MSc ^a,^b,^{^{i
On behalf of the ZAHARA investigators.}}, Willem Drenthen, MD, PhD ^a,^{^{i
On behalf of the ZAHARA investigators.}}, Barbara J.M. Mulder, MD, PhD ^c,^{^{i
On behalf of the ZAHARA investigators.}}, Jolien W. Roos-Hesselink, MD, PhD ^d,^{^{i
On behalf of the ZAHARA investigators.}}, Adriaan A. Voors, MD, PhD ^a,^{^{i
On behalf of the ZAHARA investigators.},}^{^{j
Established investigators of the Netherlands Heart Foundation (D97.017 and 2006T037).}}, Hubert W. Vliegen, MD, PhD ^e,^{^{i
On behalf of the ZAHARA investigators.}}, Philip Moons, RN, PhD ^f,^{^{i
On behalf of the ZAHARA investigators.}}, Krystyna M. Sollie, MD ^g,^{^{i
On behalf of the ZAHARA investigators.}}, Arie P.J. van Dijk, MD, PhD ^h,^{^{i
On behalf of the ZAHARA investigators.}}, Dirk J. van Veldhuisen, MD, PhD ^a,^{^{i
On behalf of the ZAHARA investigators.},}^{^{j
Established investigators of the Netherlands Heart Foundation (D97.017 and 2006T037).}}, Petronella G. Pieper, MD, PhD ^a,^{^⁎,}^{^{i
On behalf of the ZAHARA investigators.}}
^a Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
^b Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
^c Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
^d Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
^e Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
^f Department of Cardiology, University Hospitals of Leuven, Leuven, Belgium
^g Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen, The Netherlands
^h Department of Cardiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

^⁎Reprint requests: Petronella G. Pieper, MD, PhD, Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.

Résumé

Background

In women with corrected tetralogy of Fallot (ToF), pregnancy is associated with maternal cardiac, obstetric, and offspring complications. Our aim is to investigate the magnitude and determinants of pregnancy outcome in women with corrected ToF.

Methods

In this retrospective international multicenter study using 2 congenital heart disease registries, 204 women with corrected ToF were identified. Within this group, 74 women had 157 pregnancies, including 30 miscarriages and 4 terminations of pregnancy. Detailed information on each completed pregnancy (n = 123) was obtained using medical records and supplementary interviews.

Results

Cardiovascular events occurred during 10 (8.1%) pregnancies, mainly (supra)ventricular arrhythmias. Obstetric and offspring events occurred in 73 (58.9%) and 42 (33.9%) pregnancies, respectively, including offspring mortality in 8 (6.4%). The most important predictor was use of cardiac medication before pregnancy (odds ratio for cardiac events 11.7, 95% CI 2.2-62.7; odds ratio for offspring events 8.4, 95% CI 1.4-48.6). In pregnancies with cardiovascular events, significantly more small-for-gestational-age children were born (P value < .01).

Conclusions

Cardiovascular, obstetric, and offspring events occur frequently during pregnancies in women with ToF. Maternal use of cardiovascular medication is associated with pregnancy outcome, and maternal cardiovascular events during pregnancy are highly associated with offspring events.

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Plan

Patients and methods

Cardiovascular events

Cardiovascular outcome

Cardiovascular outcome

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Vol 161 - N° 2

P. 307-313 - février 2011 Retour au numéro

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Pregnancy in women with corrected tetralogy of Fallot: Occurrence and predictors of adverse events - 06/08/11

Résumé

Background

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Results

Conclusions

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