While the proportion of women considered to be at very high risk during pregnancy has risen from 1 percent in 2007 to 10 percent in 2018, fewer women with heart disease die or have heart failure during pregnancy compared with a decade ago, said researchers presenting the ROPAC study on Aug. 28 at ESC Congress 2018.

Researchers analyzed outcomes of 5,739 pregnant women with heart disease enrolled from 138 centers in 53 countries during 2007 to 2018. The average age of the women was 29.5 years and 45 percent were first-time mothers. Additionally, 57 percent of those studied had been born with congenital heart disease, and the majority had surgical correction at a young age. Other women involved in the study had valvular heart disease (29 percent), cardiomyopathy (8 percent), aortic disease (4 percent), ischemic heart disease (2 percent), and pulmonary arterial hypertension (1 percent).

Overall, finding showed less than 1 percent of women died during pregnancy or the early post-partum period, with women with pulmonary arterial hypertension having the highest rate of death at 9 percent. Rates of fetal and neonatal death were both 1 percent. Nearly half (44 percent) of women delivered by caesarean section, with more than one-third of these deliveries for cardiac reasons. Women were more likely to have complications during pregnancy if they had any of the following prior to becoming pregnant: heart failure, diminished exercise capacity, reduced ejection fraction, or use of anticoagulant medications.

"Pregnancy is safe for most women with heart disease but for some it is too risky," said Professor Jolien Roos-Hesselink, of Erasmus Medical Centre, Rotterdam, the Netherlands. "Pre-pregnancy counselling is crucial to identify women who should be advised against pregnancy, initiate timely treatment – for instance in those with severe valvular heart disease, and to discuss the risks and options."

Keywords: ESC18, ESC Congress, Pregnancy, Female, Heart Diseases, Cardiovascular Diseases, Registries

< Back to Listings