Abstract
Objective
Due to advances in medical care available for patients with congenital heart disease (CHD), these patients now have a longer life span. As a result, the number of pregnancies of mothers with CHD has increased. The purpose of the current study was to examine a possible association between being born to a mother with CHD and long-term cardiovascular morbidity of the offspring.
Study Design
A population-based cohort analysis was performed including all singleton deliveries occurring between years 1991-2014 at a single tertiary medical center.The primary exposure was defined as being born to a mother with CHD. Offspring of mothers without CHD comprised the comparison (unexposed) group. The main outcome evaluated was cardiovascular morbidity of the offspring up to the age of 18 years. A Kaplan-Meier survival curve was used to compare cumulative cardiovascular morbidity incidence. A Cox proportional hazards model was conducted to control for confounders.
Results
During the study period 242,342 deliveries met the inclusion criteria, of which 0.2% (n= 368) were of mothers who had CHD. Long-term cardiovascular morbidity was comparable between offspring to women with and without CHD (1.1% vs. 0.6%, respectively, p=0.298; Table). However, offspring of mothers with CHD had higher rates of hypertensive disorders during childhood (0.5% vs. 0.1%; p=0.021). The Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of cardiovascular morbidity in offspring of women with CHD (Figure, log rank p=0.251). In the Cox regression model, while controlling for confounders such as maternal age, preterm birth, gestational diabetes mellitus and hypertensive disorders of pregnancy, delivery of a neonate to mother with CHD was not found to be independently associated with long-term cardiovascular morbidity of the offspring.
Conclusion
Offspring of women who have congenital heart disease are not at an increased risk for long-term cardiovascular morbidity.
Due to advances in medical care available for patients with congenital heart disease (CHD), these patients now have a longer life span. As a result, the number of pregnancies of mothers with CHD has increased. The purpose of the current study was to examine a possible association between being born to a mother with CHD and long-term cardiovascular morbidity of the offspring.
Study Design
A population-based cohort analysis was performed including all singleton deliveries occurring between years 1991-2014 at a single tertiary medical center.The primary exposure was defined as being born to a mother with CHD. Offspring of mothers without CHD comprised the comparison (unexposed) group. The main outcome evaluated was cardiovascular morbidity of the offspring up to the age of 18 years. A Kaplan-Meier survival curve was used to compare cumulative cardiovascular morbidity incidence. A Cox proportional hazards model was conducted to control for confounders.
Results
During the study period 242,342 deliveries met the inclusion criteria, of which 0.2% (n= 368) were of mothers who had CHD. Long-term cardiovascular morbidity was comparable between offspring to women with and without CHD (1.1% vs. 0.6%, respectively, p=0.298; Table). However, offspring of mothers with CHD had higher rates of hypertensive disorders during childhood (0.5% vs. 0.1%; p=0.021). The Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of cardiovascular morbidity in offspring of women with CHD (Figure, log rank p=0.251). In the Cox regression model, while controlling for confounders such as maternal age, preterm birth, gestational diabetes mellitus and hypertensive disorders of pregnancy, delivery of a neonate to mother with CHD was not found to be independently associated with long-term cardiovascular morbidity of the offspring.
Conclusion
Offspring of women who have congenital heart disease are not at an increased risk for long-term cardiovascular morbidity.
| Original language | American English |
|---|---|
| Pages (from-to) | S538-S538 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 220 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2019 |