Outcomes of Pregnancy Complicated by Heart Disease at Maharaj Nakorn Chiang Mai Hospital
Thanate Jatavan MD*, Suchaya Luewan MD*, Theera Tongsong MD*
Affiliation : * Department of Obstetrics & Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To determine pregnancy outcomes of women complicated by heart disease.
Material and Method: Pregnant women complicated with heart disease between January 1993 and December 2007, at
Maharaj Nakorn Chiang Mai Hospital, were recruited to a retrospective cohort study. The normal controls were identified to
match the cases with a ratio of 2:1. The main outcomes for comparison included fetal mortality and morbidity focusing on
preterm birth and fetal growth restriction.
Results : One hundred twenty five pregnant women with heart disease and 250 controls were recruited. Rheumatic heart
disease was more common than congenital heart disease (48.8% and 44.8%). The baseline characteristics were similar
between both groups. The prevalence of operative vaginal delivery was significantly higher in the study group (32.8% and
4.4%, p < 0.001) while the cesarean section rate was similar. The prevalence of fetal death, low Apgar score, preterm births,
fetuses with low birth weight, and fetal growth restriction and were significantly higher in the study group with a relative risk
of 6.0, 3.0, 2.2, 1.92, and 1.8, respectively.
Conclusion : Rheumatic heart disease is still prevalent. The fetal outcomes especially fetal death, preterm birth, intrauterine
fetal growth restriction, low birth weight, and birth asphyxia were more common among pregnancies complicated by heart
disease.
Keywords : Pregnancy, Heart disease, Fetal outcomes
