Pregnancy outcomes among patients with complex congenital heart disease

Patients with complex congenital heart disease (CCHD) may pose a serious threat to the mother-infant safety. This study intends to explore the influencing factors for adverse pregnancy outcomes in the CCHD population. Totally 108 CCHD patients who terminated pregnancy from January 2013 to January 2023 were recruited. We collected clinical data during the pregnancy from electronic medical records. Among them, 45 patients had adverse pregnancy outcomes (41.7%) and no patient died. 5 patients with no newborn. The incidence rate of adverse pregnancy outcomes was significantly higher in patients with brain natriuretic peptide (BNP) > 100 pg/mL (OR: 2.736; 95%CI: 1.001-7.481, p = 0.049) and hypoxemia (OR: 15.46; 95%CI: 1.689-141.512, p = 0.015) and without undergoing cardiac surgical correction (OR: 3.226; 95%CI: 1.121-9.259, p = 0.03). It was confirmed by propensity score matching that no cardiac surgical correction was an independent risk factor. Maternal patients without undergoing cardiac surgical correction had poorer NYHA cardiac function (p = 0.000) and were more prone to heart failure (p = 0.027), hypoxemia (p = 0.042), pulmonary arterial hypertension (p = 0.038) and postpartum hemorrhage (p = 0.016). Moreover, these patients had prolonged Surgical Intensive Care Unit (SICU) stay (p = 0.000) and significantly higher risk of premature delivery (p = 0.005), low birth weight (p = 0.018), infection and asphyxia (p = 0.043). Corrective cardiac surgery in patients with CCHD before pregnancy significantly reduces the incidence of adverse pregnancy outcomes.