Yamini Krishnamurthy MD , Stephanie E Purisch MD , Pierre Elias MD , Timothy J Poterucha MD , Jennifer Haythe MD , Marlon Rosenbaum MD , Matthew J Lewis MD, MPH
{"title":"Association of Maternal Cardiac Disease and Echocardiographic Parameters With Neonatal Outcomes","authors":"Yamini Krishnamurthy MD , Stephanie E Purisch MD , Pierre Elias MD , Timothy J Poterucha MD , Jennifer Haythe MD , Marlon Rosenbaum MD , Matthew J Lewis MD, MPH","doi":"10.1016/j.amjcard.2025.08.049","DOIUrl":null,"url":null,"abstract":"<div><div>Women with cardiac disease have worse neonatal outcomes compared to women without cardiac disease; risk factors are not well-defined. We hypothesized that structural heart disease, as assessed by echocardiography, is a noninvasive metric for abnormal hemodynamics and an unfavorable maternal-fetal environment. We assessed the association between echocardiographic markers of structural heart disease in women with cardiac disease and a primary endpoint of adverse neonatal outcomes operationalized as neonates with small-for-gestational-age birth weight, preterm delivery, neonatal intensive care unit/transition care unit admission, or neonatal/fatal demise. Women with cardiac disease who delivered at a tertiary care center between 2014 and 2022 were included. Echocardiographic parameters and neonatal outcomes were collected. A subgroup analysis was performed among women with congenital heart disease (CHD). Among 1,108 women, maternal diagnoses of pulmonary hypertension (OR 5.7, 95% CI 1.8–18.6), hypertensive disease (OR 3.8, 95% CI 2.4–6.2), CHD (OR 2.2, 95% CI 1.3–3.8), and cardiomyopathy (OR 2.0, 95% CI 1.1–3.8) were associated with the primary endpoint. Peak tricuspid regurgitation velocity was associated with the primary endpoint (OR 1.9, 95% CI 1.2–3.1). Biventricular function and severity of valvular disease were not associated with the primary endpoint in the total study population and in the CHD subgroup. In conclusion, maternal cardiac diagnosis is associated with adverse neonatal outcomes. Structural heart disease as assessed by echocardiography was not predictive of adverse neonatal outcomes. Large-scale studies are needed to identify drivers of adverse neonatal outcomes in women with cardiac disease.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 76-82"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002914925005132","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Women with cardiac disease have worse neonatal outcomes compared to women without cardiac disease; risk factors are not well-defined. We hypothesized that structural heart disease, as assessed by echocardiography, is a noninvasive metric for abnormal hemodynamics and an unfavorable maternal-fetal environment. We assessed the association between echocardiographic markers of structural heart disease in women with cardiac disease and a primary endpoint of adverse neonatal outcomes operationalized as neonates with small-for-gestational-age birth weight, preterm delivery, neonatal intensive care unit/transition care unit admission, or neonatal/fatal demise. Women with cardiac disease who delivered at a tertiary care center between 2014 and 2022 were included. Echocardiographic parameters and neonatal outcomes were collected. A subgroup analysis was performed among women with congenital heart disease (CHD). Among 1,108 women, maternal diagnoses of pulmonary hypertension (OR 5.7, 95% CI 1.8–18.6), hypertensive disease (OR 3.8, 95% CI 2.4–6.2), CHD (OR 2.2, 95% CI 1.3–3.8), and cardiomyopathy (OR 2.0, 95% CI 1.1–3.8) were associated with the primary endpoint. Peak tricuspid regurgitation velocity was associated with the primary endpoint (OR 1.9, 95% CI 1.2–3.1). Biventricular function and severity of valvular disease were not associated with the primary endpoint in the total study population and in the CHD subgroup. In conclusion, maternal cardiac diagnosis is associated with adverse neonatal outcomes. Structural heart disease as assessed by echocardiography was not predictive of adverse neonatal outcomes. Large-scale studies are needed to identify drivers of adverse neonatal outcomes in women with cardiac disease.
期刊介绍:
Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.