Maternal arrhythmia and perinatal outcomes

• Published in: Journal of perinatology Vol. 36; no. 10; pp. 823 - 827
• Main Authors: Henry, D, Gonzalez, J M, Harris, I S, Sparks, T N, Killion, M, Thiet, M-P, Bianco, K
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.10.2016; Nature Publishing Group
• Subjects: 692/308/409; 692/699/75; Abruptio Placentae - etiology; Adult; Arrhythmia; Arrhythmias, Cardiac - complications; Arrhythmias, Cardiac - epidemiology; Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Case-Control Studies; Childbirth; Childbirth & labor; Cohort analysis; Confidence intervals; Congenital diseases; Coronary artery disease; Delivery, Obstetric - adverse effects; Female; Fetal growth retardation; Fetal Growth Retardation - etiology; Gynecology; Health aspects; Heart; Heart diseases; Humans; Infant, Newborn; Infant, Premature; Medicine; Medicine & Public Health; Obstetrics; original-article; Patient outcomes; Pediatric Surgery; Pediatrics; Pregnancy; Pregnancy Complications, Cardiovascular - epidemiology; Pregnant women; Prenatal Care - methods; Retrospective Studies; Risk Factors; Small-for-gestational age; Vagina; Womens health; Young Adult; United States; United States > US; San Francisco California; California
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2016.90

Objective: The objective of this study was to determine whether arrhythmia in the setting of maternal cardiac disease (MCD) affects perinatal outcomes. Study Design: This is a retrospective cohort study of pregnant women with MCD who delivered during 2008 to 2013. Perinatal outcomes among women with an arrhythmia were compared with those without. Results: Among 143 women, 36 (25%) had an arrhythmia. Those with an arrhythmia were more likely to have a spontaneous vaginal delivery (64 vs 43%, P <0.05) and required fewer operative vaginal births (8 vs 27%, P =0.02). Pregnancies were more likely to be complicated by intrauterine growth restriction (IUGR) (17 vs 5%, P <0.05), although there were no differences in the rate of small for gestational age. The risk of IUGR remained increased after controlling for confounding (adjusted odds ratio 6.98, 95% confidence interval 1.59 to 30.79, P =0.01). Two cases of placental abruption were identified among mothers with arrhythmia while none were identified in the controls ( P <0.05). Conclusion: Patients with arrhythmias were more likely to have a spontaneous vaginal delivery. Our data suggest that these pregnancies were an increased risk for IUGR.