Table_2_Pregnancy Complications and Outcomes Among Women With Congenital Heart Disease in Beijing, China.docx

ObjectiveTo conduct a comparative analysis of the complications and outcomes in pregnant women with and without congenital heart disease (CHD) in Beijing, China.
MethodsWe compared pregnancy-related complications and outcomes experienced by women with and without CHD throughout 19,424 deliveries in Beijing Anzhen Hospital between 2010 and 2019, including cardiovascular and obstetric factors, fetal events, delivery methods, and other complications over a mean 5-years post-delivery follow-up period.
ResultsThere were 1,040 women with CHD (5.35% of all deliveries). Compared to women without CHD, these women had longer hospital stays (7.83 ± 4.65 vs. 4.93 ± 3.26 days) and a higher death rate (1.92 vs. 0.02%). They also had a greater risk of comorbidities, including pre-term delivery (odds ratio: 13.65 vs. 6.71), heart failure (odds ratio: 4.90 vs. 0.40), and arrhythmia (odds ratio 12.69 vs. 4.69). Pulmonary hypertension, New York Heart Association functional class III~IV, and no congenital heart disease surgery prior to pregnancy were associated with adverse events such as cesarean section, pre-term delivery, and heart failure. The fetuses of mothers with CHD were more likely to be born pre-term (odds ratio: 13.65 vs. 6.71) and have low birth weight (odds ratio: 8.56 vs. 4.36). Eleven infants (1.82%) born to mothers with CHD and four infants (0.64%) born to mothers without CHD were diagnosed with CHD.
ConclusionsWomen with CHD generally increase maternal and infant risk during pregnancy and the perinatal period. Pulmonary hypertension, decrease in cardiac function, and no previous CHD surgery increase the risk in women with CHD. Greater attention should be paid to pregnant women with CHD and their fetuses, newborns.

研究目的：在中国北京开展对比分析，探讨合并与未合并先天性心脏病（congenital heart disease, CHD）的妊娠女性的并发症发生情况与妊娠结局。
研究方法：选取2010年至2019年北京安贞医院的19424例分娩病例，对比合并与未合并CHD的妊娠女性的妊娠相关并发症与妊娠结局，涵盖心血管与产科相关因素、胎儿事件、分娩方式及其他并发症，并对所有研究对象开展平均5年的产后随访。
研究结果：本队列中共1040例妊娠女性合并CHD，占总分娩数的5.35%。与未合并CHD的妊娠女性相比，合并CHD者的住院时长更长（7.83±4.65天 vs 4.93±3.26天），病死率更高（1.92% vs 0.02%）。同时，合并CHD女性的合并症风险显著升高，包括早产（比值比：13.65 vs 6.71）、心力衰竭（比值比：4.90 vs 0.40）及心律失常（比值比：12.69 vs 4.69）。肺动脉高压、纽约心脏协会（New York Heart Association, NYHA）心功能分级Ⅲ~Ⅳ级以及孕前未行先天性心脏病手术均与剖宫产、早产、心力衰竭等不良事件相关。合并CHD母亲所分娩的胎儿早产风险更高（比值比：13.65 vs 6.71），且低出生体重儿发生率更高（比值比：8.56 vs 4.36）。合并CHD母亲所分娩的婴儿中，11例（1.82%）被诊断为CHD；未合并CHD母亲所分娩的婴儿中，4例（0.64%）被诊断为CHD。
研究结论：合并CHD的妊娠女性在妊娠及围产期的母婴不良风险均显著升高。肺动脉高压、心功能下降以及孕前未行CHD手术会进一步升高合并CHD妊娠女性的不良事件风险。临床中应加强对合并CHD的妊娠女性及其胎儿、新生儿的关注与管理。