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Adverse Obstetric Outcomes in Pregnancies With Major Fetal Congenital Heart Defects
Gitte Hedermann1,2,3, Paula L Hedley1,4, Kasper Gadsbøll5
1Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark.
JAMA Pediatrics
|December 16, 2024
Summary
Women with fetal major congenital heart defects (MCHDs) face a significantly higher risk of adverse obstetric outcomes, including preeclampsia and preterm birth. Counseling should address these elevated risks for improved maternal and fetal care.
Area of Science:
- Obstetrics
- Cardiology
- Perinatology
Background:
- Major congenital heart defects (MCHDs) in fetuses can impact pregnancy outcomes.
- Understanding the specific risks of obstetric complications is vital for effective counseling and management.
Purpose of the Study:
- To investigate the association between fetal MCHDs and placenta-related adverse obstetric outcomes.
- To quantify the risk of specific complications such as preeclampsia, preterm birth, fetal growth restriction, and placental abruption.
Main Methods:
- A Danish cohort study (2008-2018) included over 534,000 pregnancies.
- Data on fetal MCHDs and obstetric outcomes were analyzed.
- Meta-analyses of existing literature were performed to supplement cohort findings.
Main Results:
- Pregnancies with fetal MCHDs had a 2.96-fold increased risk of composite adverse obstetric outcomes.
- Significant increases in preeclampsia, preterm birth (<37 weeks), and fetal growth restriction were observed.
- Most MCHD subtypes, except transposition of the great arteries, were associated with higher risks.
Conclusions:
- Nearly one in four pregnancies with fetal MCHDs (excluding transposition of the great arteries) face high risks of adverse obstetric outcomes.
- These findings underscore the importance of specialized obstetric care and counseling for pregnancies affected by MCHDs.
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