Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands.
BJOG. 2009 Nov;116(12):1593-601. doi: 10.1111/j.1471-0528.2009.02301.x. Epub 2009 Aug 13.
To compare the risks of complications during pregnancy in women with repaired and unrepaired atrial septal defects (ASDs) without associated complex cardiac lesions.
A retrospective multicentre study.
Tertiary centres in the Netherlands and Belgium.
Women with ASD without associated complex cardiac lesions.
Women were identified using two congenital heart disease registries. One hundred women were identified who had 243 pregnancies, including 49 miscarriages and six terminations of pregnancy. Detailed information on each completed pregnancy (n = 188; unrepaired ASD, n = 133; repaired ASD, n = 55) was obtained using medical records and telephone interviews. In addition, data from the Generation R database (a prospective cohort study; n = 9667) were used to determine the background risk (control group).
Adjusted odds ratios (AORs) for cardiac, obstetric and neonatal events controlled for multiple pregnancies per woman using general estimating equation analysis.
Women with an unrepaired ASD had a higher risk of neonatal events (AOR = 2.99, 95% confidence interval [CI] 1.14-7.89, P = 0.027) than women with a repaired ASD. The risk of cardiac and obstetric complications was comparable between women with unrepaired and repaired ASDs. Compared with the general population, women with an unrepaired ASD had higher risks of pre-eclampsia (AOR = 3.54, 95% CI 1.26-9.98, P = 0.017), small-for-gestational-age births (AOR = 1.95, 95% CI 1.15-3.30, P = 0.013) and fetal mortality (AOR = 5.55, 95% CI 1.77-17.4, P = 0.003). By contrast, no differences were observed when comparing women with a repaired ASD versus controls.
Women with an unrepaired ASD are at increased risk of neonatal events in comparison with women with a repaired ASD. Compared with the general population, women with an unrepaired ASD are at increased risk of pre-eclampsia, small-for-gestational-age births and fetal mortality.
比较修补与未修补房间隔缺损（ASD）而无合并复杂心脏病变的女性在妊娠期间并发症发生风险。
回顾性多中心研究。
荷兰和比利时的三级中心。
无合并复杂心脏病变的 ASD 女性。
利用两个先天性心脏病登记处识别女性。确定了 100 名女性，她们有 243 次妊娠，包括 49 次流产和 6 次终止妊娠。使用病历和电话访谈获得了每个完成妊娠的详细信息（n = 188；未修补 ASD，n = 133；修补 ASD，n = 55）。此外，还利用 Generation R 数据库（前瞻性队列研究；n = 9667）的数据确定背景风险（对照组）。
使用广义估计方程分析，对每例女性的多次妊娠进行校正后，计算心脏、产科和新生儿事件的调整优势比（AOR）。
未修补 ASD 女性的新生儿事件风险较高（AOR = 2.99，95%置信区间 [CI] 1.14-7.89，P = 0.027），而修补 ASD 女性的风险无显著差异。未修补 ASD 与修补 ASD 女性的心脏和产科并发症风险相当。与一般人群相比，未修补 ASD 女性发生子痫前期（AOR = 3.54，95% CI 1.26-9.98，P = 0.017）、小于胎龄儿（AOR = 1.95，95% CI 1.15-3.30，P = 0.013）和胎儿死亡率（AOR = 5.55，95% CI 1.77-17.4，P = 0.003）的风险较高。相比之下，修补 ASD 女性与对照组比较，差异无统计学意义。
与修补 ASD 女性相比，未修补 ASD 女性新生儿事件风险增加。与一般人群相比，未修补 ASD 女性发生子痫前期、小于胎龄儿和胎儿死亡率的风险较高。
