Outcomes of pregnancy complicated by heart disease at Maharaj Nakorn Chiang Mai Hospital

Abstract

Objective: To determine pregnancy outcomes of women complicated by heart disease. Material and Method: Pregnant women complicated with heart disease between January 1993 and December 2007, at Maharaj Nakorn Chiang Mai Hospital, were recruited to a retrospective cohort study. The normal controls were identified to match the cases with a ratio of 2:1. The main outcomes for comparison included fetal mortality and morbidity focusing on preterm birth and fetal growth restriction. Results: One hundred twenty five pregnant women with heart disease and 250 controls were recruited. Rheumatic heart disease was more common than congenital heart disease (48.8% and 44.8%). The baseline characteristics were similar between both groups. The prevalence of operative vaginal delivery was significantly higher in the study group (32.8% and 4.4%, p < 0.001) while the cesarean section rate was similar. The prevalence of fetal death, low Apgar score, preterm births, fetuses with low birth weight, and fetal growth restriction and were significantly higher in the study group with a relative risk of 6.0, 3.0, 2.2, 1.92, and 1.8, respectively. Conclusion: Rheumatic heart disease is still prevalent. The fetal outcomes especially fetal death, preterm birth, intrauterine fetal growth restriction, low birth weight, and birth asphyxia were more common among pregnancies complicated by heart disease.