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Heart failure in pregnant women with cardiac disease: data from the ROPAC

Heart (British Cardiac Society), 2014-02, Vol.100 (3), p.231-238 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2013-304888 ;PMID: 24293523

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Title:
Heart failure in pregnant women with cardiac disease: data from the ROPAC
Author: Ruys, Titia P E ; Roos-Hesselink, Jolien W ; Hall, Roger ; Subirana-Domènech, Maria T ; Grando-Ting, Jennifer ; Estensen, Mette ; Crepaz, Roberto ; Fesslova, Vlasta ; Gurvitz, Michelle ; De Backer, Julie ; Johnson, Mark R ; Pieper, Petronella G
Subjects: Adult ; Birth weight ; Cardiac arrhythmia ; Cardiomyopathy ; Cardiovascular disease ; Classification ; Developed Countries - statistics & numerical data ; Developing Countries - statistics & numerical data ; Diabetes ; Family medical history ; Female ; Fetal Mortality ; Health risk assessment ; Heart failure ; Heart Failure - epidemiology ; Heart Failure - pathology ; Heart Failure - therapy ; Hospitals ; Humans ; Incidence ; Maternal Mortality ; Mortality ; Physiology ; Preeclampsia ; Pregnancy ; Pregnancy Complications, Cardiovascular - epidemiology ; Pregnancy Complications, Cardiovascular - pathology ; Pregnancy Complications, Cardiovascular - therapy ; Pregnancy Outcome - epidemiology ; Pulmonary hypertension ; Registries ; Retrospective Studies ; Risk Factors ; Studies ; Womens health ; Young Adult
Is Part Of: Heart (British Cardiac Society), 2014-02, Vol.100 (3), p.231-238
Description: Objective Heart failure (HF) is one of the most important complications in pregnant women with heart disease, causing maternal and fetal mortality and morbidity. Methods This is an international observational registry of patients with structural heart disease during pregnancy. Sixty hospitals in 28 countries enrolled 1321 women between 2007 and 2011. Pregnant women with valvular heart disease, congenital heart disease, ischaemic heart disease, or cardiomyopathy could be included. Main outcome measures were onset and predictors of HF and maternal and fetal death. Results In total, 173 (13.1%) of the 1321 patients developed HF, making HF the most common major cardiovascular complication during pregnancy. Baseline parameters associated with HF were New York Heart Association class ≥3, signs of HF, WHO category ≥3, cardiomyopathy or pulmonary hypertension. HF occurred at a median time of 31 weeks gestation (IQR 23–40) with the highest incidence at the end of the second trimester (34%) or peripartum (31%). Maternal mortality was higher in patients with HF (4.8% in patients with HF and 0.5% in those without HF p<0.001). Pre-eclampsia was strongly related to HF (OR 7.1, 95% CI 3.9 to 13.2, p<0.001). Fetal death and the incidence of preterm birth were higher in women with HF compared to women without HF (4.6% vs 1.2%, p=0.001; and 30% vs 13%, p=0.001). Conclusions HF was the most common complication during pregnancy, and occurred typically at the end of the second trimester, or after birth. It was most common in women with cardiomyopathy or pulmonary hypertension and was strongly associated with pre-eclampsia and an adverse maternal and perinatal outcome.
Publisher: England: BMJ Publishing Group LTD
Language: English
Identifier: ISSN: 1355-6037
EISSN: 1468-201X
DOI: 10.1136/heartjnl-2013-304888
PMID: 24293523
Source: MEDLINE
ProQuest Central

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Heart failure in pregnant women with cardiac disease: data from the ROPAC

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