High-quality care is helping women with heart defects have safer pregnancies

A majority of women born with heart defects can safely become pregnant and give birth to babies that will only experience minor complications, according to new data published in the European Heart Journal. The key is simple, researchers explained: seeking out high-quality medical care. 

The study's authors evaluated a large German database, focusing on pregnancies in women with congenital heart disease (CHD) from 2005 and 2018. 

The study, the largest to look at the topic, included 7,512 pregnancies and 4,015 mothers.

No women included in the analysis died, but there were still more health complications for the mothers and babies compared with those in a control group without CHD.

The authors found that there was a minor, but elevated risk of still births or babies dying within the first month of life in those born to mothers with CHD.

In addition, those children had a six-fold increased risk of CHD compared with the control group.

“The most important finding from our study is that many women born with a congenital heart defect are able to get through pregnancy and give birth safely,” first author Astrid Lammers, MD, with Germany's University Hospital Münster, said in a prepared statement. “This is important because only a few decades ago many women would not even have reached adult age themselves. It is very encouraging to see that such a large number of mothers with a congenital heart defect can give birth to healthy children.”

In the statement, Lammers pointed out that due to advancements in neonatal support and techniques, most minor problems that do cone up can be addressed with medical support, “albeit with surgery and prolonged hospitalization.”

Even though no women in the CHD group died during pregnancy and up to 90 days after the delivery, it was reported that one woman in the non-CHD group died.

In general, complications were low overall. However, women with CHD had a notably higher rate of stroke (1.13% versus 0.17%), heart failure (0.84% versus 0.03%) and abnormal heart rhythm problems (0.82% versus 0.12%) compared with women who did not have CHD.

Caesarean deliveries were also more prevalent among CHD patients (40.5% vs. 31.5%)

“Our findings should help to inform mothers-to-be with CHD what to expect in terms of neonatal complications and to direct them to appropriate care providers if they wish to start a family," Lammers added. "Counseling is a very important part of the care of every woman with a congenital heart defect and should start at an early age. It appears to work in developed countries such as Germany, as suggested by the lack of deaths among the mothers. This is probably due to avoiding very high-risk pregnancies and appropriate management of pregnancy."

The full study can be found here

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