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Risk Factors and Outcomes Associated With Hypertensive Disorders of Pregnancy in Maternal Congenital Heart Disease

Sarah A Goldstein1, Anamaria Savu2, Sunjidatul Islam3

  • 1Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.

JACC. Advances
|June 28, 2024
PubMed

Insights

Hypertensive disorders of pregnancy (HDP) are more common in women with congenital heart disease (CHD). Acquired conditions, not CHD itself, are key risk factors for HDP and adverse pregnancy outcomes.

Area of Science:

  • Cardiology
  • Obstetrics
  • Public Health

Background:

  • Congenital heart disease (CHD) in pregnant women presents unique risks.
  • Risk factors for hypertensive disorders of pregnancy (HDP) and their outcomes in women with CHD are not well understood.

Purpose of the Study:

  • To identify risk factors for HDP in pregnant women with and without CHD.
  • To assess the association between HDP and adverse pregnancy outcomes in this population.

Main Methods:

  • Retrospective cohort study of live births in Alberta, Canada (2005-2018).
  • Comparison of HDP prevalence between women with and without CHD.
  • Multivariable models to determine associations between maternal characteristics, HDP, and adverse events.

Main Results:

  • HDP occurred more frequently in women with CHD (11.2% vs 8.1%).
  • Chronic hypertension and diabetes were significant risk factors for HDP in women with CHD.
  • Coarctation of the aorta was the only CHD lesion linked to increased HDP risk.
  • HDP, more than CHD, strongly correlated with complicated delivery, preterm birth, and small for gestational age infants.

Conclusions:

  • Hypertensive disorders of pregnancy are more prevalent in women with congenital heart disease.
  • Acquired conditions are the primary risk factors for HDP in women with CHD.
  • HDP, rather than CHD, is more strongly associated with adverse pregnancy outcomes.
Abstract

Keywords:
congenital heart diseasehypertensive disorders of pregnancyoutcomespreeclampsia

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