INTRODUCTION: The number of pregnancies of women with cardiac disease (CD) has been increasing. Previous studies on outcomes were reported mainly on maternal cardiac outcome.
OBJECTIVE: We focused on the outcome of infants who were born to mothers with CD.
METHODS: Study subjects consisted of 596 singleton live-born infants who were born at Tokyo Women's Medical University Hospital from 1991 to 2005. Women with maternal CD included 295 with congenital heart disease (CHD), 184 with arrhythmias, 84 with acquired valvular disease, 18 with cardiomyopathy, and 16 with miscellaneous CD. Gestational age, birth weight (BW), mortality rate, and complications in the subjects and long-term outcome of the preterm infants (<37 weeks' gestation) were evaluated.
RESULTS: Preterm birth was found in 74 (12.4%) infants, 3 of whom were born at <28 weeks' gestation. Low BW was found in 117 (19.6%) infants, 12 of whom weighed <1500 g. Rates of preterm birth (61%) and low BW (61%) in the infants of mothers with cardiomyopathy were significantly higher than those with other maternal CD. The overall mortality rate was 0.7%; 3 died (1 with Down syndrome with CHD, 1 with neonatal Marfan syndrome, and 1 extremely low BW infant born at 23 weeks' gestation) in the neonatal period, and 1 infant with CHD died at 1 year of age. Seven of the preterm infants (9.5%) had CHD. Other complications included anomalies/chromosomal disorders (5), cerebral palsy (1), mental retardation (2), borderline mentality (1), and hearing impairment (1). The prevalence of major neurologic handicap was 4%.
CONCLUSIONS: The rates of preterm birth and low BW were very high. Adverse outcome of infants born to mothers with CD was related to congenital disorders including CD of offspring and extremely preterm birth.
Submitted by Yumi Kono
- Copyright © 2008 by the American Academy of Pediatrics