Maternal Comorbidities and Complications of Delivery in Pregnant Women With Congenital Heart Disease.

Pregnant women with congenital heart defects (CHDs) may be at increased risk for adverse events during delivery. This study sought to compare comorbidities and adverse cardiovascular, obstetric, and fetal events during delivery between pregnant women with and without CHDs in the United States. Comorbidities and adverse delivery events in women with and without CHDs were compared in 22,881,691 deliveries identified in the 2008 to 2013 National Inpatient Sample using multivariable logistic regression. Among those with CHDs, associations by CHD severity and presence of pulmonary hypertension (PH) were examined. There were 17,729 deliveries to women with CHDs (77.5 of 100,000 deliveries). These women had longer lengths of stay and higher total charges than women without CHDs. They had greater odds of comorbidities, including PH (adjusted odds ratio [aOR]: 193.8; 95% confidence interval [CI]: 157.7 to 238.0), congestive heart failure (aOR: 49.1; 95% CI: 37.4 to 64.3), and coronary artery disease (aOR: 31.7; 95% CI: 21.4 to 47.0). Greater odds of adverse events were observed, including heart failure (aOR: 22.6; 95% CI: 20.5 to 37.3), arrhythmias (aOR: 12.4; 95% CI: 11.0 to 14.0), thromboembolic events (aOR: 2.4; 95% CI: 2.0 to 2.9), pre-eclampsia (aOR: 1.5; 95% CI: 1.3 to 1.7), and placenta previa (aOR: 1.5; 95% CI: 1.2 to 1.8). Cesarean section, induction, and operative vaginal delivery were more common, whereas fetal distress was less common. Among adverse events in women with CHDs, PH was associated with heart failure, hypertension in pregnancy, pre-eclampsia, and pre-term delivery; there were no differences in most adverse events by CHD severity. Pregnant women with CHDs were more likely to have comorbidities and experience adverse events during delivery. These women require additional monitoring and care.

Schlichting LE ，Insaf TZ ，Zaidi AN ，Lui GK ，Van Zutphen AR ... -  《-》

Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease.

Hayward RM ，Foster E ，Tseng ZH 《-》

Obstetric and perinatal outcomes in pregnancies with isolated foetal congenital heart abnormalities.

Liu C ，Lodge J ，Flatley C ，Gooi A ，Ward C ，Eagleson K ，Kumar S ... -  《-》

Association between maternal chronic conditions and congenital heart defects: a population-based cohort study.

Liu S ，Joseph KS ，Lisonkova S ，Rouleau J ，Van den Hof M ，Sauve R ，Kramer MS ，Canadian Perinatal Surveillance System (Public Health Agency of Canada) ... -  《-》

Maternal and perinatal outcomes of extreme obesity in pregnancy.

Crane JM ，Murphy P ，Burrage L ，Hutchens D ... -  《-》