Patient Perceptions and Knowledge Surrounding Pregnancy After Heart Transplantation: A Multicenter Study

Area of Science:

• Cardiology
• Transplantation Medicine
• Reproductive Health

Background:

• Increasing survival rates for women of childbearing age post-heart transplantation (HT).
• Many HT survivors express a desire for pregnancy.
• Limited data exist on patient perspectives regarding contraception, pregnancy, breastfeeding, and medication safety after HT.

Purpose of the Study:

• To evaluate patient perspectives on reproductive health counseling after heart transplantation.
• To assess knowledge and receipt of counseling regarding contraception, pregnancy, breastfeeding, and medication safety post-HT.
• To identify gaps in care for women desiring post-transplant pregnancy.

Main Methods:

• A voluntary, confidential, web-based cross-sectional survey was administered.
• Participants included women of childbearing age (18-45 years) at the time of HT.
• Data were collected from 6 high-volume US HT centers between January 2005 and January 2020.

Main Results:

• 64 women responded; 39.1% were pregnant before HT, and 9.4% had pregnancies post-transplant.
• 53% felt they lacked sufficient pre-HT pregnancy information; 26% did not discuss pregnancy potential with their care team.
• 44% still felt uninformed about pregnancy post-HT, and 20% believed pregnancy was never safe.

Conclusions:

• Many heart transplant recipients feel inadequately counseled on post-transplant reproductive health.
• There is a significant opportunity to enhance provider education and patient communication.
• Improved support is needed for women with HT who desire to become pregnant post-transplant.