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Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis
BACKGROUND: With advances in the treatment of congenital heart disease (CHD), more women with CHD survive childhood to reach reproductive age. The objective of this study was to evaluate the maternal and neonatal outcomes of pregnancies among women with CHD in the modern era. METHODS AND RESULTS: We...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174159/ https://www.ncbi.nlm.nih.gov/pubmed/33821681 http://dx.doi.org/10.1161/JAHA.120.017834 |
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author | Hardee, Isabel Wright, Lydia McCracken, Courtney Lawson, Emily Oster, Matthew E. |
author_facet | Hardee, Isabel Wright, Lydia McCracken, Courtney Lawson, Emily Oster, Matthew E. |
author_sort | Hardee, Isabel |
collection | PubMed |
description | BACKGROUND: With advances in the treatment of congenital heart disease (CHD), more women with CHD survive childhood to reach reproductive age. The objective of this study was to evaluate the maternal and neonatal outcomes of pregnancies among women with CHD in the modern era. METHODS AND RESULTS: We conducted a meta‐analysis of peer‐reviewed literature published January 2007 through June 2019. Studies were included if they reported on maternal or fetal mortality and provided data by CHD lesion. Meta‐analysis was performed using random effect regression modeling using Comprehensive Meta‐Analysis (v3). CHD lesions were categorized as mild, moderate, and severe to allow for pooling of data across studies. Of 2200 articles returned by our search, 32 met inclusion criteria for this study. Overall, the rate of neonatal mortality was 1%, 3.1%, and 3.5% in mild, moderate, and severe lesions, respectively. There were too few maternal deaths in any group to pool data. The rates of maternal and neonatal morbidity among women with CHD increase with severity of lesion. Specifically, rates of maternal arrhythmia and heart failure, cesarean section, preterm birth, and small for gestational age neonate are all markedly increased as severity of maternal CHD increases. CONCLUSIONS: In the modern era, pregnancy in women with CHD typically has a successful outcome in both mother and child. However, as maternal CHD severity increases, so too does the risk of numerous morbidities and neonatal mortality. These findings may help in counseling women with CHD who plan to become pregnant, especially women with severe lesions. |
format | Online Article Text |
id | pubmed-8174159 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81741592021-06-11 Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis Hardee, Isabel Wright, Lydia McCracken, Courtney Lawson, Emily Oster, Matthew E. J Am Heart Assoc Systematic Review and Meta‐analysis BACKGROUND: With advances in the treatment of congenital heart disease (CHD), more women with CHD survive childhood to reach reproductive age. The objective of this study was to evaluate the maternal and neonatal outcomes of pregnancies among women with CHD in the modern era. METHODS AND RESULTS: We conducted a meta‐analysis of peer‐reviewed literature published January 2007 through June 2019. Studies were included if they reported on maternal or fetal mortality and provided data by CHD lesion. Meta‐analysis was performed using random effect regression modeling using Comprehensive Meta‐Analysis (v3). CHD lesions were categorized as mild, moderate, and severe to allow for pooling of data across studies. Of 2200 articles returned by our search, 32 met inclusion criteria for this study. Overall, the rate of neonatal mortality was 1%, 3.1%, and 3.5% in mild, moderate, and severe lesions, respectively. There were too few maternal deaths in any group to pool data. The rates of maternal and neonatal morbidity among women with CHD increase with severity of lesion. Specifically, rates of maternal arrhythmia and heart failure, cesarean section, preterm birth, and small for gestational age neonate are all markedly increased as severity of maternal CHD increases. CONCLUSIONS: In the modern era, pregnancy in women with CHD typically has a successful outcome in both mother and child. However, as maternal CHD severity increases, so too does the risk of numerous morbidities and neonatal mortality. These findings may help in counseling women with CHD who plan to become pregnant, especially women with severe lesions. John Wiley and Sons Inc. 2021-04-06 /pmc/articles/PMC8174159/ /pubmed/33821681 http://dx.doi.org/10.1161/JAHA.120.017834 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Systematic Review and Meta‐analysis Hardee, Isabel Wright, Lydia McCracken, Courtney Lawson, Emily Oster, Matthew E. Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title | Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title_full | Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title_fullStr | Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title_full_unstemmed | Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title_short | Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta‐Analysis |
title_sort | maternal and neonatal outcomes of pregnancies in women with congenital heart disease: a meta‐analysis |
topic | Systematic Review and Meta‐analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174159/ https://www.ncbi.nlm.nih.gov/pubmed/33821681 http://dx.doi.org/10.1161/JAHA.120.017834 |
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