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Maternal heart disease and perinatal outcome
S V Mane1, V P Gharpure, R H Merchant
1Division of Obstetrics, Nowrosjee Wadia Maternity Hospital, Bombay.
Indian Pediatrics
|December 1, 1993
Summary
Maternal heart disease, particularly rheumatic heart disease, did not impact perinatal outcomes. However, infants born to mothers with severe heart disease (NYHA Class III or IV) experienced intrauterine growth retardation.
Area of Science:
- Cardiology
- Obstetrics & Gynecology
- Perinatology
Background:
- Heart disease in pregnancy presents unique challenges for both mother and fetus.
- Rheumatic heart disease remains a significant etiological factor in many pregnant populations worldwide.
- Understanding the impact of maternal heart disease severity on pregnancy outcomes is crucial for clinical management.
Purpose of the Study:
- To evaluate the perinatal outcomes in singleton pregnancies complicated by heart disease.
- To assess the influence of rheumatic versus nonrheumatic heart disease on maternal and fetal health.
- To investigate the correlation between New York Heart Association (NYHA) functional classification of heart disease and infant birth weight.
Main Methods:
- Retrospective analysis of 62 singleton pregnancies with heart disease managed between January 1991 and August 1992.
- Categorization of heart disease into rheumatic and nonrheumatic origins.
- Classification of rheumatic heart disease severity using the New York Heart Association (NYHA) criteria (Class I-IV).
- Comparison of birth weights between infants of mothers with varying degrees of heart disease and a control group of uncomplicated pregnancies.
Main Results:
- The majority of heart disease cases (82.3%) were of rheumatic origin.
- No maternal mortality was recorded during the study period.
- Infants born to mothers with NYHA Class III or IV rheumatic heart disease had significantly lower birth weights compared to uncomplicated pregnancies (p < 0.05).
- A significant difference in birth weight was observed between infants of mothers with NYHA Class I/II and Class III/IV disease (p < 0.05).
- No congenital heart defects were noted in the neonates.
Conclusions:
- Maternal heart disease, irrespective of its severity, did not adversely affect the overall perinatal outcome in this cohort.
- Intrauterine growth retardation was a significant finding in infants born to mothers with severe heart disease (NYHA Class III or IV).
- Close monitoring and management are essential for pregnancies complicated by severe maternal heart disease to mitigate risks of intrauterine growth retardation.