Study: Pregnancy and Congenital Heart Disease

Pregnant women with congenital heart disease are more likely to have a cesarean section despite having a very low risk of irregular heartbeats or other heart-related complications during labor and delivery.

Pertinent Points:

- Pregnant women with congenital heart disease are more likely to have a c-section and remain in the hospital longer, according to a review of California deliveries.

- Otherwise, the risk of complications was not as high as expected.

In presenting evidence at the American Heart Association’s Scientific Sessions last month, cardiologist Robert M. Hayward, MD, a cardiac electrophysiology fellow of the University of California in San Francisco, also said these women were likely to have longer hospital stays after giving birth.

"We are pleased to find the risk of complications are not as high as expected in women with congenital heart disease," Hayward said in a news release. "While we don't know why these women have longer hospital stays, it's possible their doctors are keeping them admitted for extra observation."

For the study, the researchers combed through medical records of more than 2.7 million women who gave birth in California. Among this group, 3,218 women had non-complex congenital heart disease and 248 women had complex congenital heart disease, defined as women whose conditions were more advanced and likely warranted surgical treatment during early childhood.

Nearly half (47%) of the women with complex congenital heart disease, and 40% of those with non-complex congenital heart disease, had a c-section. To compare, 33% of women without congenital heart disease had a c-section.

On average, women with complex congenital heart disease remained in the hospital for 5 days, while those with non-complex congenital heart disease stayed 3.4 days. Women without congenital heart disease were discharged in 2.5 days.

Despite the large population review, Hayward cautioned that the study only provided a snapshot of caring for women with congenital heart disease during pregnancy and specifically did not include information on the postpartum health of the mother.

"The data allows us to see associations, but it does not suggest any cause and effect," Hayward said. "We'd like to look at the period after delivery to see if there were any new admissions, heart failure, or other complications to develop a better understanding of the health needs of maternal patients with congenital heart disease."

He also noted that their study did not look at the health of the infant during or after pregnancy.