The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Risk and Predictors for Pregnancy-Related Complications in Women With Heart Disease
Abstract
Background The physiological changes of pregnancy can result in cardiovascular complications in the mother, which in turn may have fetal implications. Prior studies have focused on specific cardiac lesions or identified univariate predictors. There is a need to refine the risk stratification of women with heart disease so they can receive appropriate obstetrical counseling and care. Methods and Results We examined the outcomes of 221 women with heart disease who underwent 276 pregnancies and received their obstetrical care at three Toronto hospitals from 1986 through 1994. Those who underwent therapeutic abortions were excluded. Among the study participants, there were 24 miscarriages and 252 completed pregnancies (pregnancies not ending in miscarriage). Maternal heart failure, arrhythmia, or stroke occurred in 45 completed pregnancies (18%). There were no maternal deaths. Poor maternal functional class or cyanosis, myocardial dysfunction, left heart obstruction, prior arrhythmia, and prior cardiac events were predictive of maternal cardiac complications. These predictors were incorporated into a point score that can be used to estimate the probability of a cardiac complication in the mother. The rate of cardiac complications for a patient with 0, 1, and >1 of the above factors was 3%, 30%, and 66%, respectively. Neonatal complications occurred in 42 completed pregnancies (17%). Neonatal events included death (2), respiratory distress syndrome (16), intraventricular hemorrhage (2), premature birth (35), and small-for-gestational-age birth weight (14). Poor maternal functional class or cyanosis was predictive of neonatal events. Conclusions Despite low maternal and neonatal mortality, pregnancy in women with heart disease is associated with significant cardiac and neonatal morbidity. The probability of maternal cardiac or neonatal events can be predicted from baseline characteristics of the mother.
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Cites
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Cited by
Warnes, C. A., Williams, R. G., Bashore, T. M., Child, J. S., Connolly, H. M., Dearani, J. A., del Nido, P., Fasules, J. W., Graham, T. P., Hijazi, Z. M., et al. (2008) · Circulation · doi:10.1161/circulationaha.108.190811 · Cited by 2,066
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease
Warnes, C. A., Williams, R. G., Bashore, T. M., Child, J. S., Connolly, H. M., Dearani, J. A., del Nido, P., Fasules, J. W., Graham, T. P., Hijazi, Z. M., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.10.001 · Cited by 1,533
Predictors of pregnancy complications in women with congenital heart disease
Drenthen, W., Boersma, E., Balci, A., Moons, P., Roos-Hesselink, J. W., Mulder, B. J. M., Vliegen, H. W., van Dijk, A. P. J., Voors, A. A., Yap, S. C., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq200 · Cited by 706
Silversides, C. K., Harris, L., Haberer, K., Sermer, M., Colman, J. M., & Siu, S. C. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.11.041 · Cited by 255
Atrial Fibrillation or Flutter During Pregnancy in Patients With Structural Heart Disease
Salam, A. M., Ertekin, E., van Hagen, I. M., Al Suwaidi, J., Ruys, T. P. E., Johnson, M. R., Gumbiene, L., Frogoudaki, A. A., Sorour, K. A., Iserin, L., et al. (2015) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2015.04.013 · Cited by 79
Metadata
- Authors
- SM, S. C. S., Sermer, M., Harrison, D. A., Grigoriadis, E., Liu, G., Sorensen, S., BS, J. F. S., Farine, D., Amankwah, K. S., Spears, J. C., & Colman, J. M.
- Venue
- Circulation
- Published
- 1997-11-04
- Volume
- 96
- Issue
- 9
- Pages
- 2789-2794
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2064036546
- Cited by
- 318
- References
- 21
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- closed
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- SM, S. C. S., Sermer, M., Harrison, D. A., Grigoriadis, E., Liu, G., Sorensen, S., BS, J. F. S., Farine, D., Amankwah, K. S., Spears, J. C., & Colman, J. M. (1997). Risk and Predictors for Pregnancy-Related Complications in Women With Heart Disease. Circulation. https://doi.org/10.1161/01.cir.96.9.2789
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