Women who were born with heart defects may get some reassurance from a new study that finds they face no heightened risk to health during a pregnancy and delivery.
According to the researchers, doctors may often advise these women against getting pregnant due to the potential risks for them and their babies, but until now those risks have been unclear.
“The most important finding from our study is that many women born with a congenital heart defect are able to get through pregnancy and give birth safely. This is important because only a few decades ago many women would not even have reached adult age themselves,” said study co-author Dr. Astrid Lammers.
“It is very encouraging to see that such a large number of mothers with a congenital heart defect can give birth to healthy children,” added Lammers, a consultant in pediatric cardiology at University Hospital Münster, in Germany.
Still, expert medical care and counseling are key, the study authors said.
For the study, the researchers analyzed data from more than 7,500 pregnancies among more than 4,000 German women with a congenital heart defect. The investigators compared them with more than 11,200 pregnancies in a control group of about 6,500 women without heart defects.
No one with a congenital heart defect died during pregnancy and up to 90 days after delivery, while one woman in the control group died, according to the report.
Complications among all the women were low overall. However, women with a congenital heart defect had significantly higher rates of stroke (1.13% versus 0.17%), heart failure (0.84% versus 0.03%) and abnormal heart rhythm problems (0.82% versus 0.12%) compared to the other group.
Women with a heart defect also had a higher rate of cesarean delivery than those in the control group: 41% versus 32%.
Compared to babies in the control group, those born to mothers with a congenital heart defect had a higher risk of stillbirth, death within the first month of life, and low or extremely low birthweight. They were also more likely to be born prematurely, require mechanical ventilation, have major visible abnormalities, and have Down syndrome or other genetic syndromes.
Babies born to mothers with a congenital heart defect were also more likely to have a congenital heart defect, too, and more likely to require heart surgery with heart-lung machine support by 6 years of age.
The complexity of the mother’s heart defect, high blood pressure, heart failure, blood-thinning treatment with vitamin K antagonists in the year before pregnancy and prior fertility treatment were all significant predictors of problems in babies of mothers with a heart defect, according to the study, which was published Oct. 12 in the European Heart Journal.
“We do report health problems around the time of birth, which are relevant and important. However, thanks to advanced neonatal support and techniques, a majority of these problems can be overcome with medical support, albeit with surgery and prolonged hospitalization,” Lammers said in a journal news release.
The fact that there were not deaths among women with a congenital heart defect was “unexpected and fantastic news,” Jolien Roos-Hesselink and Dr. Karishma Ramlakhan wrote in an accompanying editorial.
That’s “an important message and should lead to a change in policy from approaching pregnancy as potentially very dangerous, to considering pregnancy as relatively safe and explaining the possible risks, on the condition that women in [the very highest risk group] should not become pregnant,” according to the two experts from Erasmus University Medical Center Rotterdam, in the Netherlands.
The American Heart Association has more on congenital heart defects.
SOURCE: European Heart Journal, news release, Oct. 13, 2021
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