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Uterine rupture and long-term cardiovascular hospitalization of the offspring
Roy Bitan1, Tamar Wainstock2, Daniela Landau3
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Pregnancy complications like uterine rupture increase offspring cardiovascular hospitalization risk. Newborns delivered after uterine rupture require long-term cardiovascular monitoring due to this heightened risk.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Cardiology
- Epidemiology
Background:
- Uterine rupture is linked to severe maternal and neonatal complications.
- The long-term cardiovascular health impact on offspring following uterine rupture remains under-investigated.
Purpose of the Study:
- To investigate the association between uterine rupture and cardiovascular hospitalizations in offspring up to age 18.
- To determine if uterine rupture is an independent risk factor for pediatric cardiovascular disease.
Main Methods:
- Population-based cohort study comparing cardiovascular hospitalizations in singletons born after uterine rupture versus controls.
- Exclusion criteria included multiple gestations, perinatal deaths, and congenital abnormalities.
- Kaplan-Meier survival curves and Cox proportional hazards models were used for analysis.
Main Results:
- 127 (0.053%) of 238,622 eligible newborns were born after uterine rupture.
- Offspring born following uterine rupture exhibited significantly higher rates of cardiovascular-related hospitalizations (p=.005).
Conclusions:
- Birth following uterine rupture is an independent risk factor for long-term pediatric cardiovascular hospitalizations.
- Increased Cesarean section rates may correlate with long-term offspring cardiovascular issues.
- Cardiovascular surveillance is recommended for newborns delivered after uterine rupture.
Background:
Uterine rupture is associated with severely adverse maternal and neonatal outcomes. The association between uterine rupture and long-term cardiovascular hospitalization of the offspring has not been investigated yet.
Methods:
In a population-based cohort study, the incidence of cardiovascular related hospitalizations was compared between singletons born to mothers with and without uterine rupture in the current pregnancy. Cardiovascular hospitalization up to the age of 18 years was assessed according to a predefined set of ICD-9 codes associated with offspring hospitalization. Multiple gestations, perinatal deaths, lacking prenatal care, and children with congenital malformations or chromosomal abnormalities were excluded from the study. A Kaplan-Meier survival curve was used to assess cumulative incidence of cardiovascular hospitalization of the offspring. A Cox proportional hazards model was performed to control for confounders.
Results:
During the study period, 238,622 newborns met the inclusion criteria, of which 0.053% (n = 127) were born to mothers with uterine rupture in the current pregnancy. Children born to mothers with uterine rupture had significantly higher rates of cardiovascular related hospitalization (Kaplan-Meier's survival curve log-rank test, p=.005).
Conclusion:
Being born following uterine rupture is an independent risk factor for long-term pediatric cardiovascular hospitalization.HighlightsUterine rupture is a risk factor for long-term pediatric cardiovascular related hospitalization.Rising rate of CS potentially associate to long-term offspring cardiovascular disease.Cardiovascular surveillance is needed for newborns delivered after uterine rupture.
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