Congenital valvular heart disease in pregnancy : analyzing risk factors of delivering low birth weight neonates Karina Niken Pratiwi, Pangeran Akbar Syah, Ardhia Kusuma Putri, Oktavia Lilyasari, Radityo Prakoso
Congenital valvular heart disease in pregnancy :
analyzing risk factors of delivering low birth
weight neonates
Karina Niken Pratiwi, Pangeran Akbar Syah, Ardhia Kusuma Putri, Oktavia Lilyasari,
Radityo Prakoso
Background : Pregnancy Complicated With Heart
Disease
Valvular Heart
DIseaseChristine M, Warrick MD, Jan E, et al. Prevalence and descriptive analysis of congenital heart disease in parturients : obstetric, nenonatal,and aesthetic outcomes
1 – 3% of all pergnancies
Responsible for 10 – 15% of fetal and
maternal morbidity
Fetus and neonate at risk of : SGA, Prematurity, IUFD, neonatal death,
low birth weight
Pregnancy and Valvular Heart Disease
Congenital cardiac lesions are 3 times
higher than acquired
Affecting heamodynamic
changes
Rao S, ginns JN. Adult congenitalheat disease and pregnancy. Seminars of perinatology. 2014
Hemodynamic changes in pregnancy, labor and postpartum
Adapted from Cornetter and
Ross-Hesselink
MethodsData were collected through a year period from April 2013 – April 2014 in Cipto Mangunkusumo
General Hospital Incomplete records were
excluded
142 Pregnancy Complicated with Congenital Heart
Disease42 Congenital Heart Disease
Diagnosed by clinical examination,
electrocardiograph, laboratory, chest x-ray,
echocardiograph examination
• maternal age• parity• Ejection Fraction• Week of gestation• MAP
• anemia during antenatal care (ANC), labor
Risk Factors
Bivariate and multivariate analysis using SPSS
Results
Maternal Risk factors of low birth weight in Valvular Congenital Heart Disease in Pregnancy:
Bivariate Analysis
Maternal Risk factors of Valvular heart disease in pregnancy for Low birth weight neonates : Multivariate
Analysis
Variable p-value Adjusted OR* 95%CIPreterm birth 0.009*
0.052
0.006 – 0.483
Multiparous 0.169 0.312 0.059 – 1.642
DiscussionThis Study Other studiesPrevalence Congenital Heart Disease in Pregnancy
142/ 4561 CHD in pregnancy
117/18.226 CHD in pregnancy (Warrick CM et al )
Prevalence Congenital Valvular Heart Disease in Pregnancy
30% (42/142) Valvular Heart Disease in pregnancy with CHD
• Preterm birth (aOR 0.052)
• Multiparous
P<0.05 P>0.05
Premature birth rate appeared higher in patients with more complex CHD. Premature birth tend to deliver
nenonates with low birth weight
Warrick CM et al. Prevalence and descriptive analysis of congenital heart disease in parturients: obstetric, neonatal, and anesthetic outcomes. Journal of clinical Aesthesia. 2015
ConclusionsPreterm birth in women with congenital valvular
heart disease were the risk factor of Delivering low birth weight neonates.