Fetal and Obstetric Complications Among Pregnant Women With Congenital Heart Disease in a Georgia Medicaid Dataset

IF 2 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2026-07-08 DOI:10.1002/bdr2.70085

Cheryl L. Raskind-Hood, Travis M. Wilson, Shayli Patel, Fred H. Rodriguez III, Alex Haffner, Vijaya Kancherla, Lindsey Ivey, Wendy M. Book

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Abstract

Background

Survival to reproductive age is common among women with congenital heart disease (CHD). We evaluated fetal and obstetric complications in a population-based cohort of women with CHD enrolled in Georgia (GA) Medicaid.

Methods

We identified 3904 pregnancies (96.0% singleton) among 2267 women with CHD, ages 11–50 (49.2% Black; 76.3% urban), enrolled in GA Medicaid from 2008 to 2019. Diagnoses and outcomes were defined using International Classification of Diseases (ICD) codes. Associations between CHD anatomic group and fetal and obstetric outcomes were assessed using chi-square tests. Multivariate logistic regression models were adjusted for covariates, using isolated coronary anomalies as the reference group.

Results

Obstetric complications occurred in 36.2% of pregnancies and did not differ significantly by CHD anatomic group (p = 0.5301). Fetal complications were significantly more common in all CHD groups compared with coronary anomalies, including higher prematurity and fetal growth restriction (FGR) rates (prematurity: p < 0.0001; FGR: p = 0.0238). In multivariate analysis, complex right ventricular outflow tract (RVOT) defects, shunts, univentricular lesions, transposition of the great arteries (TGA), left-sided and right-sided valve lesions were associated with increased odds of fetal complications compared to coronary anomaly CHD [aOR, 95% CI: complex RVOT 4.85, 1.85–12.71; shunt 4.00, 1.56–10.26; univentricular: 3.65, 1.35–9.90; TGA: 3.64, 1.24–10.63; left-sided valve: 3.23, 1.26–8.31; and right-sided valve: 3.11, 1.19–8.12].

Conclusions

Pregnancies among women with CHD carry increased risk of prematurity and FGR rates across CHD anatomic groups compared with coronary anomalies. Close monitoring for fetal and obstetric complications is warranted regardless of CHD subtype, including those traditionally considered to have lower maternal risk.

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乔治亚州医疗补助数据集中先天性心脏病孕妇的胎儿和产科并发症

背景：先天性心脏病（CHD）妇女存活到生育年龄是常见的。我们评估了在乔治亚州（GA）医疗补助计划登记的冠心病妇女人群队列中的胎儿和产科并发症。方法：我们在2267名11-50岁的冠心病女性（49.2%为黑人，76.3%为城市）中确定了3904例妊娠（96.0%为单胎），这些女性在2008年至2019年期间参加了GA医疗补助计划。使用国际疾病分类（ICD）代码定义诊断和结果。采用卡方检验评估冠心病解剖组与胎儿和产科结局之间的关系。以孤立的冠状动脉异常作为参照组，对多变量logistic回归模型进行协变量校正。结果：妊娠期产科并发症发生率为36.2%，冠心病解剖组间差异无统计学意义（p = 0.5301）。与冠状动脉异常相比，胎儿并发症在所有冠心病组中都更为常见，包括更高的早产和胎儿生长受限（FGR）率（早产：p）。结论：与冠状动脉异常相比，冠心病解剖组中怀孕的冠心病妇女早产和FGR率增加。密切监测胎儿和产科并发症是必要的，无论冠心病亚型，包括那些传统上认为具有较低的产妇风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.