| Warrick et al., 2015 [12] | 1) Assess prevalence of congenital heart disease (CHD), 2) Describe outcomes of pregnancies in women with CHD, 3) Compare outcomes in women with and without CHD, and 4) Characterize neonatal outcomes in pregnancies complicated by CHD. | 117 pregnancies in 110 women with CHD | University of Colorado Hospital | Retrospective cohort study | We identified 117 pregnancies in 110 women with CHD. Parturient with CHD were more likely to have operative vaginal delivery (P = 0.0001), neonatal ICU admissions (P = 0.003), and had prolonged hospital stays. Occurrence of CHD in neonates was 6%. Moderate-to-severe valvular disease was associated with increased rates of operative vaginal delivery, early initiation of neuraxial labor analgesia, cardiac complications (including arrhythmia and use of diuretics), prolonged hospital stay, and maternal ICU admission. However most deliveries and births were uncomplicated; and there were one case each of maternal mortality and fetal death after birth. |
| Schlichting et al., 2019 [19] | Compare comorbidities and adverse cardiovascular, obstetric, and fetal events during delivery between pregnant women with and without CHDs in the United States. | Women with and without CHDs were compared in 22,881,691 deliveries. There were 17,729 deliveries to women with CHDs | A nationally representative sample of discharges from hospitals in the United States | Stratified, cross-sectional observational design | There were approximately 22,881,691 deliveries in the United States between 2008 and 2013. Among the delivery hospitalizations, 17,729 were to women with CHDs, Women with CHD had higher comorbidities in comparison with women without CHDs. cardiac events including heart failure, arrhythmia, and thromboembolic events were significantly greater among pregnant women with CHDs than pregnant women without. Women with CHDs are at an increased risk for numerous cardiovascular, obstetric, and fetal events at the time of delivery. The odds of an adverse maternal cardiac event during delivery were 2.4 to 27.6 times higher for women with CHDs compared with women without. Among the cardiac events examined, the odds of heart failure during delivery were the highest, Women with CHDs also showed significantly increased odds of other adverse obstetric events, including pre-term delivery, hemorrhage, and placental abruption. Infants born to mothers with CHDs were more likely to possess birth defects or exhibit growth restriction at birth, but less likely to experience fetal distress. These infants may experience growth restriction. |
| Karamlou et al., 2011 [17] | Determined the national prevalence of GUCH parturients, their diagnostic makeup, and whether they have increased risk of peripartum complications, maternal or fetal death. | A total of 39.9 million births occurred, 26,973 (0.07%) of which were GUCH | Nationwide Inpatient Sample (NIS) is a stratified, Cross-sectional database in the US | Cross-sectional retrospective design | The GUCH parturients, especially those with VSD, have increased risk of mortality and peripartum complications compared with other age-matched women. The GUCH women had a significantly higher prevalence of all peripartum complications studied compared with non-GUCH women, including preterm delivery (10.2% vs 7.2%), induction (35.6% vs 32.5%), surgically assisted delivery (11.8% vs 7.9%), and caesarean birth (33.6% vs 27.2%) (p = 0.001 for all). Hospital length of stay was similar for both GUCH and non GUCH women and was 2.5 days. |