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Cardiovascular Disease Among Women and Birthing Individuals After Delivering a Child With Congenital Heart Disease
Stephanie S Colello1, Richard F Ittenbach2, Brenna Klepczynski3
1Division of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Insights
Mothers of children with congenital heart disease (CHD) showed similar cardiovascular disease risks compared to controls. However, greater child CHD severity correlated with higher maternal cardiovascular disease risk, warranting further investigation.
Area of Science:
- Cardiology
- Maternal Health
- Pediatric Cardiology
Background:
- Maternal cardiovascular disease (CVD) risk is elevated following childbirth involving congenital heart disease (CHD).
- The underlying mechanisms linking maternal CVD risk and offspring CHD remain largely uncharacterized.
Purpose of the Study:
- To determine the prevalence of CVD and associated risk factors in mothers 18–23 years post-delivery of a child with CHD.
- To compare these rates against normative data from a matched control population.
Main Methods:
- A cross-sectional survey was administered to mothers of infants with CHD who had undergone cardiac surgery between 1998-2003.
- Maternal CVD and risk factor data were compared to age- and sex-matched individuals from the National Health and Nutrition Examination Survey (NHANES).
Main Results:
- Of 533 mothers contacted, 222 (42%) completed the survey. Mean maternal age was 52 years.
- Common risk factors included high cholesterol (32%), hypertension (27%), and preterm delivery (32%).
- Overall, 15.3% reported CVD; atherosclerotic CVD and risk factor rates were similar to NHANES controls. Higher child CHD severity correlated with maternal CVD (P=0.03).
Conclusions:
- Mothers of children with CHD exhibit comparable rates of CVD and risk factors to controls 18–23 years postpartum.
- Increased child CHD severity is linked to a higher risk of maternal CVD.
- Further research is needed to elucidate this association and its clinical implications.
Background:
Individuals have a higher risk of cardiovascular disease later in life if they give birth to a child with congenital heart disease (CHD). The mechanism of this association has not been well documented.
Objectives:
The authors aimed to describe the prevalence of cardiovascular disease and risk factors in women and birthing individuals 18 to 23 years after delivery of a child with CHD compared to normative data.
Methods:
A cross-sectional survey was distributed to mothers whose infants with CHD had undergone cardiac surgery in 1998 to 2003 and previously enrolled in a prospective observational study. We compared rates of cardiovascular disease and risk factors to age- and sex-matched parous women and birthing individuals from National Health and Nutrition Examination Survey.
Results:
An attempt was made to contact 533 mothers; 222 (42%) completed the survey. The mean age was 52 years, 86% were White, and 69% completed college. Common cardiovascular risk factors were high cholesterol (32%), hypertension (27%), preterm delivery (32%), and hypertensive disorder of pregnancy (13%). Overall, 15.3% reported presence of cardiovascular disease as defined by atherosclerotic cardiovascular disease, heart failure, valvular disease, or arrhythmia. A higher severity of child's CHD was significantly associated with self-reported maternal cardiovascular disease (P = 0.03). Compared to National Health and Nutrition Examination Survey participants, rates of atherosclerotic cardiovascular disease and cardiovascular risk factors were similar.
Conclusions:
Women and birthing individuals whose children had CHD had similar rates of cardiovascular risk factors and disease at 18 to 23 years after delivery, compared to age- and sex-matched parous controls. Higher severity of child's CHD was associated with increased risk of maternal cardiovascular disease, an association that should be evaluated in future studies.
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