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心脏病孕妇并发症的预测因素:一项回顾性研究

Predictors for complications in pregnant women with heart disease, a retrospective study.

作者信息

Chumpathong Saowapark, Sirithaweesit Chuleeporn, Pechpaisit Nuchsaroch, Suraseranivongse Suwannee, von Bormann Benno, Titapant Vitaya, Parakkamodom Sudta

出版信息

J Med Assoc Thai. 2014 Jul;97(7):730-5.

PMID:25265772
Abstract

OBJECTIVE

Evaluate the CARPREG score in predicting cardiac, obstetric, and neonatal complications in pregnant women with heart disease.

MATERIAL AND METHOD

This was a retrospective study between 2002 and 2011 at a tertiary care center and included 175 pregnant women with heart disease. Maternal and neonatal outcomes were assessed using Cardiac in Pregnancy Score (CARPREG), which included NYHA-class, systolic ejection fraction, left ventricular obstruction, and history of cardiac events.

RESULTS

Rheumatic heart disease (n = 116, 66.3%) was the predominant cardiac problem. CARPREG score was 0, 1, > 1 in 65.1%, 24.6%, and 10.3% pregnancies, respectively. Maternal cardiac events occurred in 27.4%. CARPREG score > or = 1 was associated with an increased rate of cardiac events [odds ratio (OR) 6.76, 95% confidence interval (CI) 3.26 to 14.01]. Fetal complications occurred 24.4%. Neonatal birth weight < 2,500 g was associated with CARPREG score > or = 1 (OR 2.57, 95% CI 1.29 to 5.11).

CONCLUSION

Maternal cardiac events can be predicted using CARPREG risk index. In Thai population, rheumatic heart disease was the most frequent form of cardiac problems in pregnant women.

摘要

目的

评估CARPREG评分对预测心脏病孕妇的心脏、产科及新生儿并发症的作用。

材料与方法

这是一项于2002年至2011年在一家三级护理中心开展的回顾性研究,纳入了175例心脏病孕妇。使用妊娠心脏评分(CARPREG)评估孕产妇和新生儿结局,该评分包括纽约心脏协会(NYHA)分级、收缩期射血分数、左心室梗阻及心脏事件史。

结果

风湿性心脏病(n = 116,66.3%)是主要的心脏问题。CARPREG评分在65.1%、24.6%和10.3%的妊娠中分别为0、1、>1。孕产妇心脏事件发生率为27.4%。CARPREG评分>或=1与心脏事件发生率增加相关[比值比(OR)6.76,95%置信区间(CI)3.26至14.01]。胎儿并发症发生率为24.4%。新生儿出生体重<2500 g与CARPREG评分>或=1相关(OR 2.57,95%CI 1.29至5.11)。

结论

可使用CARPREG风险指数预测孕产妇心脏事件。在泰国人群中,风湿性心脏病是孕妇最常见的心脏问题类型。

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