Table 1

Examples of studies with reports on maternal and fetal outcome in pregnant women with heart diseases

StudyDescriptionGeneral maternal outcome%Obstetric/fetal outcome%
Sliwa K et al15 2020 JACC Heart FailMaternal and fetal outcomes of women with uncorrected CHD (n=1059). 10-year data from the European Society of Cardiology registry including 53 countriesMaternal mortality0.7Pregnancy induced hypertension4
Major adverse cardiac events (MACE)11.6HELLP or pre/eclampsia4
Heart failure8.7Caesarean section42
Hospitalisation during pregnancy15Post-partum haemorrhage4
Supraventricular and ventricular arrhythmia0.6Premature birth13.8
Endocarditis and thromboembolism1.1Intra uterine growth retardation7
Low Apgar score6
Fetal death1
Neonatal death1.5
Adverse fetal outcome17.2
Khairy P et al 2006.
Circulation19
Pregnancy outcomes in women with CHD in a single centre, Brigham and Women’s Hospital, Boston, MA, USA. (n=53 women with total of 90 pregnancies).Pulmonary oedema16.7Adverse neonatal outcomes27.8
Sustained arrhythmia2.8Pre-term delivery20.8
Maternal death0Small for gestational age8.3
Combined maternal cardiac events19.4Respiratory distress syndrome8.3
Intrauterine fetal death2.8
Neonatal death1.4
Spontaneous abortion12.2
Elective pregnancy termination7.8
Drenthen W et al 2007. J Am Coll ardiol.24A literature review on complications associated with pregnancy in women with structural CHD from 1985 to 2007. (n=2491 pregnancies)Heart failure4.8Overall miscarriages15
Arrhythmias4.5Overall elective abortion5
Overall mortality4Overall fetal mortality4
Thromboembolic complications2.2Overall premature birth16
Pre-eclampsia3.2
Ford AA et al 2008. Obstet Gynecol.20Retrospective analysis of contemporary perinatal and cardiac outcomes of pregnancies in women with major structural CHD from 2000 to 2007. Single Centre study Columbia University Medical Center, New York. (n=69 women with 74 deliveries)Combined adverse cardiac events20.2Combined adverse obstetric events45.9
Maternal death7Caesarean delivery41.9
Heart failure9.5Pre-eclampsia9.5
Significant arrhythmias2.7Pre-term delivery17.7
Small for gestational age21.6
Warrik C et al 2015. J Clin Anesth.21A retrospective analysis of women who delivered at the University of Colorado Hospital. (n=18 226, with 110 with CHD and 117 pregnancies)Maternal death0.9Fetal death0.8
Rezk M et al 2016
Arch Gynecol Obstet26
Prospective assessment of maternal and fetal outcome in women with RHD. 3-year, single-centre observational study in Egypt (n=192 pregnant women with RHD)Heart failure24.5Small for gestational age19.8
Significant arrhythmias9.9Prematurity26.0
Thromboembolism10.9Intra-uterine fetal death2.6
Delivery by caesarean section50Neonatal ICU admission34.9
Post-partum haemorrhage12.5Neonatal death3.1
Maternal mortality2.6
Lin JH et al 2007. Zhonghua Fu Chan Ke Za Zhi.28Single-centre evaluation of pregnant women with RHD from January 1993 to July 2006 in China (n=65)Peri-natal mortality5Pre-term labour28
Medical abortion18.9
Intra-uterine fetal retardation6
Sartain JB et al 2012
Intern Med J27
Single-centre maternal cardiac complications and obstetric outcomes in patients with RHD in Australia from 1999 to 2010. (n=54 women with total of 95 pregnancies)Maternal death0Neonatal death0
Cardiac complications8Caesarean section32.6
Post-partum haemorrhage2.1
Stergiopoulos K et al 2015,
Am J Cardiol22
Risk and risk factors for adverse maternal and fetal events in pregnant women with underlying heart disease in New York. (n=173 pregnancies)Heart failure23Underweight21
Sustained arrhythmia19Premature birth19
Maternal clinical events49Respiratory distress19
MACE20Fetal death2
Preterm labour11
Preterm delivery18
Fetal adverse clinical events22
Siu et al3 2011
Circulation
Prospective multicenter (13 centres) study of pregnancy outcomes in women with heart disease in Canada.
(n=562 women with 599 pregnancies).
Maternal primary cardiac event13Combined neonatal complications20
Combined maternal primary and secondary cardiac events17Small for gestational age3.7
CVA0.6Premature delivery17.5
Fetal death1
Neonatal death1
Preterm labour10
Avila et al23 2003
Clin Cardiology
Single-centre outcome of pregnant women with cardiac disease in Brazil. (n=1000)Heart failure12%Stillbirth2.9
Cardiac arrhythmias6Prematurity12
Thromboembolism2CHD2.2
Angina1.4
Infective endocarditis0.5
Maternal mortality2.7
Campanharo et al25 2015 PLOS oneCross-sectional study of all deliveries in 27 referral obstetric units in Brazil. (n=9555 pregnant women; 293 with heart disease)Hospital admission24Neonatal death4.1
Maternal death4.8Low birth weight45
Roos-Hesselink et al2 2013, European Heart JournalOutcome of pregnancy in patients with structural or ischaemic heart disease in Europe. (n=1321 pregnant women)Maternal death1Caesarean section41
All hospitalisation26Fetal mortality1.7
Heart failure hospitalisation10.1Neonatal mortality0.6
Supra ventricular arrhythmias0.9Pregnancy induced hypertension2.4
Ventricular arrhythmias2.0Pre-eclampsia3.3
Caesarean section41
Post-partum haemorrhage2.9
  • CHD, congenital heart disease; HELLP, Hemolysis, Elevated Liver enzymes and Low Platelets; RHD, rheumatic heart disease.