Pregnancy outcomes in women with aortic coarctation
Open accessAbstract
OBJECTIVE: Pregnancy in women with aortic coarctation (CoA) has an estimated moderately increased risk (mWHO II-III) of adverse cardiovascular, obstetric or fetal events, but prospective data to validate this risk classification are scarce. We examined pregnancy outcomes and identified associations with adverse outcomes. METHODS: Pregnancies in women with CoA were selected from the worldwide prospective Registry of Pregnancy and Cardiac Disease (ROPAC, n=303 out of 5739), part of the European Society of Cardiology EURObservational Research Programme. The frequency of and associations with major adverse cardiac events (MACE) and hypertensive disorders (pregnancy-induced hypertension, (pre-)eclampsia or haemolysis, elevated liver enzymes and low platelets syndrome) were analysed. RESULTS: Of 303 pregnancies (mean age 30 years, pregnancy duration 39 weeks), 9.6% involved unrepaired CoA and 27.1% were in women with pre-existing hypertension. No maternal deaths or aortic dissections occurred. MACE occurred in 13 pregnancies (4.3%), of which 10 cases were of heart failure (3.3%). Univariable associations with MACE included prepregnancy clinical signs of heart failure (OR 31.8, 95% CI 6.8 to 147.7), left ventricular ejection fraction <40% (OR 10.4, 95% CI 1.8 to 59.5), New York Heart Association class >1 (OR 11.4, 95% CI 3.6 to 36.3) and cardiac medication use (OR 4.9, 95% CI 1.3 to 18.3). Hypertensive disorders of pregnancy occurred in 16 (5.3%), cardiac medication use being their only predictor (OR 3.2, 95% CI 1.1 to 9.6). Premature births were 9.1%, caesarean section was performed in 49.7% of pregnancies. Of 4 neonatal deaths, 3 were after spontaneous extreme preterm birth. CONCLUSIONS: The ROPAC data show low MACE and hypertensive disorder rates during pregnancy in women with CoA, suggesting pregnancy to be more safe and better tolerated than previously appreciated.
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Pregnancy is generally well tolerated by women who have undergone aortic coarctation repair.
“Pregnancy is generally well tolerated by women who have undergone aortic coarctation repair.520”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [520]
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Cites
2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy
Regitz-Zagrosek, V., Roos-Hesselink, J. W., Bauersachs, J., Blomström-Lundqvist, C., Cífková, R., De Bonis, M., Iung, B., Johnson, M. R., Kintscher, U., Kranke, P., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy340 · Cited by 2,292 · see citing works
Self-citationBrown, M. A., Magee, L. A., Kenny, L. C., Karumanchi, S. A., McCarthy, F. P., Saito, S., Hall, D. R., Warren, C. E., Adoyi, G., & Ishaku, S. (2018) · Hypertension · doi:10.1161/hypertensionaha.117.10803 · Cited by 2,089 · see citing works
Global epidemiology of use of and disparities in caesarean sections
Boerma, T., Ronsmans, C., Melesse, D. Y., Barros, A. J. D., Barros, F. C., Juan, L., Moller, A., Say, L., Hosseinpoor, A. R., Mu, Y., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31928-7 · Cited by 1,558 · see citing works
Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
Ananth, C. V., Keyes, K. M., & Wapner, R. J. (2013) · BMJ · doi:10.1136/bmj.f6564 · Cited by 940 · see citing works
Pierpont, M. E., Brueckner, M., Chung, W. K., Garg, V., Lacro, R. V., McGuire, A. L., Mital, S., Priest, J. R., Pu, W. T., Roberts, A., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000606 · Cited by 654 · see citing works
Roos‐Hesselink, J. W., Ruys, T. P. E., STEIN, J. I., Thilén, U., Webb, G. D., Niwa, K., Kaemmerer, H. M., Baumgartner, H., Budts, W., Maggioni, A. P., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs270 · Cited by 462 · see citing works
Self-citationRoos‐Hesselink, J. W., Baris, L., Johnson, M. R., Backer, J. F. A. D., Otto, C. M., Marelli, A. J., Jondeau, G., Budts, W., Grewal, J., Sliwa, K. S., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz136 · Cited by 432 · see citing works
Self-citationHistopathologic findings in human aortic media associated with pregnancy.
Manalo-Estrella, P., & Barker, A. (1967) · PubMed · Cited by 348 · see citing works
Brown, M. L., Burkhart, H. M., Connolly, H. M., Dearani, J. A., Cetta, F., Li, Z., Oliver, W. C., Warnes, C. A., & Schaff, H. V. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.06.016 · Cited by 296 · see citing works
Coarctation of the aorta: outcome of pregnancy
Beauchesne, L., Connolly, H. M., Ammash, N. M., & Warnes, C. A. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01617-5 · Cited by 285 · see citing works
Is a planned caesarean section in women with cardiac disease beneficial?
Ruys, T. P. E., Roos‐Hesselink, J. W., Pijuan‐Domenech, A., et al. (2014) · Heart · doi:10.1136/heartjnl-2014-306497 · Cited by 167 · see citing works
Self-citationHypertension after repair of aortic coarctation — A systematic review
Canniffe, C., Ou, P., Walsh, K. P., et al. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.09.084 · Cited by 162 · see citing works
Outcome of pregnancy in patients after repair of aortic coarctation
Vriend, J. W. J., Drenthen, W., Pieper, P. G., Roos‐Hesselink, J. W., Zwinderman, A. H., van Veldhuisen, D. J., & Mulder, B. J. M. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi338 · Cited by 148 · see citing works
Self-citationIschemic Stroke in Children and Young Adults With Congenital Heart Disease
Mandalenakis, Z., Rosengren, A., Lappas, G., Eriksson, P., Hansson, P., & Dellborg, M. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.003071 · Cited by 134 · see citing works
Late outcomes in adults with coarctation of the aorta
Choudhary, P., Canniffe, C., Jackson, D., et al. (2015) · Heart · doi:10.1136/heartjnl-2014-307035 · Cited by 129 · see citing works
Ersbøll, A., Hedegaard, M., Søndergaard, L., Ersbøll, M., & Johansen, M. (2014) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.12522 · Cited by 102 · see citing works
Cardiac medication during pregnancy, data from the ROPAC
Ruys, T. P. E., Maggioni, A. P., Johnson, M. R., Sliwa, K. S., Tavazzi, L., Schwerzmann, M., Nihoyannopoulos, P., Koželj, M., Marelli, A. J., Elkayam, U., et al. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.09.013 · Cited by 98 · see citing works
Self-citationIn-utero exposure to antihypertensive medication and neonatal and child health outcomes
Fitton, C. A., Steiner, M. F. C., Aucott, L. S., Pell, J. P., Mackay, D., Fleming, M., & McLay, J. S. (2017) · Journal of Hypertension · doi:10.1097/hjh.0000000000001456 · Cited by 77 · see citing works
Haematological problems in obstetrics
Rodger, M. A., Sheppard, D., Gándara, E., & Tinmouth, A. T. (2015) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2015.02.004 · Cited by 73 · see citing works
Krieger, E. V., Landzberg, M. J., Economy, K. E., Webb, G. D., & Opotowsky, A. R. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.01.033 · Cited by 72 · see citing works
Stroke in Adults With Coarctation of the Aorta: A National Population‐Based Study
Pickard, S. S., Gauvreau, K., Gurvitz, M. Z., Gagne, J. J., Opotowsky, A. R., Jenkins, K. J., & Prakash, A. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009072 · Cited by 67 · see citing works
Outcome of pregnancy following intervention for coarctation of the aorta
Saidi, A. S., Bezold, L. I., Altman, C. A., et al. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00443-3 · Cited by 60 · see citing works
Jiménez‐Juan, L., Krieger, E. V., Valente, A. M., et al. (2013) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jet161 · Cited by 39 · see citing works
PREGNANCY AND COARCTATION OF THE AORTA*1
Goodwin, J. F. (1958) · The Lancet · doi:10.1016/s0140-6736(58)92514-5 · Cited by 29 · see citing works
Siegmund, A. S., Kampman, M. A. M., Bilardo, C. M., et al. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.09.167 · Cited by 24 · see citing works
Satō, H., Kamiya, C., Sawada, M., et al. (2017) · Pregnancy Hypertension · doi:10.1016/j.preghy.2017.05.005 · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [19]WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. Geneva World Health Organization; 2011. 23741776
- [22]WHO WHO recommendations non-clinical interventions to reduce unnecessary caesarean sections. Geneva World Health Organization; 2018. 30398818
Cited by
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
Gravholt, C. H., Andersen, N. H., Christin-Maitre, S., Davis, S. M., Duijnhouwer, A., Gawlik, A., Maciel-Guerra, A. T., Gutmark-Little, I., Fleischer, K., Hong, D., et al. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae050 · Cited by 224 · see citing works
- Authors
- Ramlakhan, K. P., Tobler, D., Greutmann, M., Schwerzmann, M., Baris, L., Yetman, A. T., Nihoyannopoulos, P., Manga, P., Boersma, E., Maggioni, A. P., Johnson, M. R., Hall, R., & Roos-Hesselink, J. W.
- Affiliations
- Erasmus MC (NL)
- University of Basel (CH)
- University Hospital Zurich (CH)
- University of Bern (CH)
- Children's Hospital & Medical Center (US)
- Hammersmith Hospital (GB)
- University of the Witwatersrand (ZA)
- European Society of Cardiology (FR)
- Chelsea and Westminster Hospital (GB)
- University of East Anglia (GB)
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
- ORCID
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2020-10-29
- Volume
- 107
- Issue
- 4
- Pages
- 290-298
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- PMC
- PMC7873427
- OpenAlex
- W3097739813
- Cited by
- 42
- References
- 26
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 7 · 2021: 5
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Heart (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- ResMed Foundation
- Bristol-Myers Squibb
- Stichting Zabawas
- Sanofi
- Daiichi Sankyo Company
- Servier
- Boehringer Ingelheim
- Boston Scientific Corporation
- Vifor Pharma
- Merck Sharp and Dohme
- Fondazione Internazionale Menarini
- Bayer
- Novartis Pharma
- De Hoop Foundation
- Eli Lilly and Company
- Edwards Lifesciences
- Gedeon Richter
- AstraZeneca
- Abbott Vascular Int.
- Pfizer
- Amgen
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- coarctation of the aorta, pregnancy outcomes, major adverse cardiac events, hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, HELLP syndrome, heart failure, left ventricular ejection fraction, preterm birth, cesarean section, neonatal death
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