患有母体和胎儿心脏病的孕妇的胎儿/新生儿和产科不良结局。
Adverse fetal/neonatal and obstetric outcomes in pregnancies with both maternal and fetal heart disease.
机构信息
Division of Cardiology, University of Toronto, Pregnancy and Heart Disease Program, Mount Sinai and Toronto General Hospitals, Toronto, ON, Canada.
Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
出版信息
J Perinatol. 2024 Oct;44(10):1424-1431. doi: 10.1038/s41372-024-02058-3. Epub 2024 Jul 23.
OBJECTIVE
To investigate fetal/neonatal and obstetric events in pregnancies with both maternal and fetal heart disease.
STUDY DESIGN
From the CARPREG database, singleton pregnancies (>24 weeks) in patients with structural heart disease that underwent fetal/neonatal echocardiograms were selected and separated in two groups: maternal heart disease only (M-HD) and maternal and fetal heart disease (MF-HD). Differences in adverse fetal/neonatal (death, preterm birth, and small for gestational age) and obstetric (preeclampsia/eclampsia) outcomes between groups were analyzed.
RESULTS
From 1011 pregnancies, 93 had MF-HD. Fetal/neonatal events (38.7% vs 25.3%, p = 0.006) and spontaneous preterm birth (10.8% vs 4.9%, p = 0.021) were more frequent in MF-HD compared to M-HD, with no difference in obstetric events. MF-HD remained as a significant predictor of fetal/neonatal events after adjustment (OR:1.883; 95% CI:1.182-3.000; p = 0.008).
CONCLUSIONS
Pregnancies with MF-HD are at risk of adverse fetal/neonatal events and spontaneous preterm birth. Larger studies are needed to determine their association with preeclampsia.
目的
研究患有母体和胎儿心脏病的妊娠中胎儿/新生儿和产科事件。
研究设计
从 CARPREG 数据库中选择了患有结构性心脏病且接受胎儿/新生儿超声心动图检查的单胎妊娠（>24 周），并将其分为两组：仅母体心脏病（M-HD）和母体和胎儿心脏病（MF-HD）。分析两组之间不良胎儿/新生儿（死亡、早产和小于胎龄儿）和产科（子痫前期/子痫）结局的差异。
结果
在 1011 例妊娠中，有 93 例为 MF-HD。MF-HD 组胎儿/新生儿事件（38.7%比 25.3%，p=0.006）和自发性早产（10.8%比 4.9%，p=0.021）的发生率高于 M-HD 组，但产科事件无差异。MF-HD 在调整后仍然是胎儿/新生儿事件的显著预测因素（OR：1.883；95%CI：1.182-3.000；p=0.008）。
结论
MF-HD 妊娠存在不良胎儿/新生儿事件和自发性早产的风险。需要更大的研究来确定它们与子痫前期的关系。
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