Department of Cardiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Eur Heart J. 2013 Mar;34(9):657-65. doi: 10.1093/eurheartj/ehs270. Epub 2012 Sep 11.
To describe the outcome of pregnancy in patients with structural or ischaemic heart disease.
In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and IHD in 2%. Maternal death occurred in 1%, compared with 0.007% in the normal population. Highest maternal mortality was found in patients with CMP. During pregnancy, 338 patients (26%) were hospitalized, 133 for heart failure. Caesarean section was performed in 41%. Foetal mortality occurred in 1.7% and neonatal mortality in 0.6%, both higher than in the normal population. Median duration of pregnancy was 38 weeks (range 24-42) and median birth weight 3010 g (range 300-4850). In centres of developing countries, maternal and foetal mortality was higher than in centres of developed countries (3.9 vs. 0.6%, P < 0.001 and 6.5 vs. 0.9% P < 0.001)
The vast majority of patients can go safely through pregnancy and delivery as long as adequate pre-pregnancy evaluation and specialized high-quality care during pregnancy and delivery are available. Pregnancy outcomes were markedly worse in patients with CMP and in developing countries.
描述结构性或缺血性心脏病患者的妊娠结局。
2007 年，欧洲心脏病学会启动了欧洲妊娠和心脏病登记处。连续入组患有瓣膜性心脏病、先天性心脏病、缺血性心脏病（IHD）或心肌病（CMP）并伴有妊娠的患者。正常人群的数据来自文献。28 个国家的 60 家医院在 2007 年至 2011 年间共入组了 1321 名孕妇。产妇的中位年龄为 30 岁（范围 16-53 岁）。大多数患者处于纽约心脏协会（NYHA）心功能Ⅰ级（72%）。最常见的是先天性心脏病（66%），其次是瓣膜性心脏病（25%）、CMP（7%）和 IHD（2%）。产妇死亡率为 1%，而正常人群为 0.007%。CMP 患者的产妇死亡率最高。在妊娠期间，338 名患者（26%）住院，133 名因心力衰竭住院。41%的患者行剖宫产术。胎儿死亡率为 1.7%，新生儿死亡率为 0.6%，均高于正常人群。中位妊娠持续时间为 38 周（范围 24-42 周），中位出生体重为 3010g（范围 300-4850g）。在发展中国家的中心，产妇和胎儿死亡率高于发达国家（3.9%对 0.6%，P<0.001；6.5%对 0.9%，P<0.001）。
只要有充分的孕前评估和妊娠及分娩期间的专业高质量护理，绝大多数患者都可以安全地度过妊娠和分娩期。CMP 患者和发展中国家的妊娠结局明显较差。
