Sidlik Rakefet, Sheiner Eyal, Levy Amalia, Wiznitzer Arnon
Department of Obstetrics & Gynecology, Faculty of Health Services, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Matern Fetal Neonatal Med. 2007 Mar;20(3):211-6. doi: 10.1080/14767050600923980.
The primary objective of this study was to characterize the delivery outcome of parturients with congenital heart defects (CHD), from maternal and from neonatal perspectives.
A retrospective population-based study was conducted, covering a 13-year period (1989-2002) with an aggregate of 151,487 deliveries of all women with and without CHD. Maternal demographics, obstetrical and medical history, delivery outcome, and neonatal outcome were drawn from a computerized perinatal database.
Sixty-seven women with CHD had 156 deliveries. The severity of CHD, based on the New York Heart Association (NYHA) classification, was I or II in 99.1% of the deliveries. CHD patients had significantly higher rates of labor induction and neonatal malformations. Maternal CHD was discovered as an independent risk factor associated with neonatal malformations (OR 2.10, 95% CI 1.18-3.72). No significant differences were noted between women with CHD and the controls regarding maternal morbidities and Apgar scores.
The labor outcome of CHD patients with NYHA classification I and II resembles that of non-CHD women in a tertiary center setting. Neonates of CHD mothers have higher rates of congenital malformations even among asymptomatic or mildly symptomatic mothers. A careful sonographic follow-up is warranted among all pregnancies of CHD patients.
本研究的主要目的是从母亲和新生儿的角度描述先天性心脏病（CHD）产妇的分娩结局。
进行了一项基于人群的回顾性研究，涵盖13年期间（1989 - 2002年），共有151,487例分娩，包括患有和未患有CHD的所有女性。产妇的人口统计学特征、产科和病史、分娩结局以及新生儿结局均来自计算机化的围产期数据库。
67例患有CHD的女性共分娩156次。根据纽约心脏协会（NYHA）分类，CHD的严重程度在99.1%的分娩中为I级或II级。CHD患者的引产率和新生儿畸形率显著更高。发现产妇CHD是与新生儿畸形相关的独立危险因素（OR 2.10，95% CI 1.18 - 3.72）。在产妇发病率和阿氏评分方面，CHD患者与对照组之间未发现显著差异。
在三级中心环境中，NYHA分类为I级和II级的CHD患者的分娩结局与非CHD女性相似。即使在无症状或症状轻微的母亲中，CHD母亲的新生儿先天性畸形率也较高。对于CHD患者的所有妊娠，都需要进行仔细的超声随访。
