Chien Shao-Ju, Lin Ying-Jui, Lo Mao-Hung, Huang Chien-Fu, Yang Yao-Hsu
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
Department of Early Childhood Care and Education, Cheng Shiu University, Kaohsiung, Taiwan.
Front Pediatr. 2021 Jul 14;9:687276. doi: 10.3389/fped.2021.687276. eCollection 2021.
The objective of this research was to evaluate the fertility of Taiwanese women with diagnoses of congenital heart diseases (CHDs). The study also investigated how different forms of CHDs may have variously influenced fertility. We directed this nationwide, population-based and retrospective matched-cohort research by using data from the Taiwan National Health Insurance Research Database. The CHD group ( = 6602) included women with congenital structural heart diseases, aged 16-45 years in 2000. The non-CHD group ( = 6602) was matched according to urbanization and income. The outcomes, involving live birth, abortion, and fertility rates, were followed until the end of 2013. Poisson regression was used to evaluate the incidence rate ratios (IRRs). The CHDs had an inferior rate of live births (IRR 0.74 [95% CI 0.71-0.78]) than the non-CHD group. There was also a lower fertility rate in the CHD group (IRR 0.81 [95% CI 0.78-0.84]) than the non-CHD group. Abortion rates between the two groups were similar. Congenital structural heart disease compromises female fertility, even among patients with simple forms of CHDs. It is suggested that pregnant patients with CHDs are early appeared to and advised personally with multidisciplinary care to improve their outcomes.
本研究的目的是评估被诊断患有先天性心脏病（CHD）的台湾女性的生育能力。该研究还调查了不同类型的先天性心脏病如何对生育能力产生不同影响。我们利用台湾国民健康保险研究数据库的数据开展了这项全国性、基于人群的回顾性匹配队列研究。先天性心脏病组（n = 6602）包括2000年年龄在16至45岁之间患有先天性结构性心脏病的女性。非先天性心脏病组（n = 6602）根据城市化程度和收入进行匹配。对包括活产、流产和生育率在内的结局进行随访，直至2013年底。采用泊松回归评估发病率比（IRR）。先天性心脏病组的活产率（IRR 0.74 [95% CI 0.71 - 0.78]）低于非先天性心脏病组。先天性心脏病组的生育率（IRR 0.81 [95% CI 0.78 - 0.84]）也低于非先天性心脏病组。两组之间的流产率相似。先天性结构性心脏病会损害女性生育能力，即使是患有简单类型先天性心脏病的患者。建议先天性心脏病孕妇尽早接受多学科护理并得到个性化建议，以改善其妊娠结局。
