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Maternal and neonatal outcomes among pregnant women with cardiovascular disease in the Philippines: a retrospective cross-sectional study from 2015-2019.
Rivera, Frederick Berro; Magalong, John Vincent; Tantengco, Ourlad Alzeus; Mangubat, Gerard Francis; Villafuerte, Mary Grace; Volgman, Annabelle Santos.
Afiliación
  • Rivera FB; Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines.
  • Magalong JV; Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines.
  • Tantengco OA; College of Medicine, University of the Philippines Manila, Manila, Philippines.
  • Mangubat GF; Department of Medicine, Southern Philippines Medical Center, Davao City, Philippines.
  • Villafuerte MG; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of the Philippines - Philippine General Hospital, Manila, Philippines.
  • Volgman AS; Department of Cardiology, Rush University Medical Center, Chicago, IL, USA.
J Matern Fetal Neonatal Med ; 35(25): 9922-9933, 2022 Dec.
Article en En | MEDLINE | ID: mdl-35634711
PURPOSE: Several studies link maternal cardiovascular disease (CVD) to maternal and fetal morbidity and mortality. This study describes the profile of maternal, obstetric, and neonatal outcomes among pregnant women with CVD in a tertiary hospital in the Philippines. It identifies the clinical and sociodemographic variables associated with these outcomes. MATERIALS AND METHODS: A single-center, retrospective analysis of pregnant women admitted for delivery at the Philippine General Hospital from 2015 to 2019 was performed. Of these patients, pregnant women with CVD were identified as the cohort for this study. Data on clinical and sociodemographic factors, maternal major adverse cardiovascular events, neonatal adverse clinical events, and obstetric complications were collected. Logistic regression analysis was performed to determine the odds ratio for the risk factors for small-for-gestational-age (SGA) babies and preterm birth. RESULTS: Among 30,053 delivery admissions in the Philippine General Hospital from 2015 to 2019, 293 (0.98%) pregnant women had CVD. Of the CVDs present in this cohort, congenital heart diseases (n = 119, 40.6%) were the most common, followed by rheumatic heart disease (n = 109, 37.2%). Maternal adverse events were rarely observed. Four women experienced symptomatic arrhythmias, two presented with worsening heart failure, three experienced thromboembolic events, and one had cerebrovascular infarction. There was no reported maternal death, cardiac arrest, shock, or acute renal failure. The majority (69.3%) of the women included in the study were delivered by spontaneous vaginal delivery and assisted vaginal delivery by vacuum or forceps; however, a significant portion of these women had undergone cesarean section. Almost all the study cohort delivered live births, with most neonates being delivered at 37-38 weeks gestational age (83.6%) and only 16.0% born preterm. However, a significant portion, a third of the neonates, were classified as having low birth weight. Around 17.4% of neonates born from gravidocardiac mothers were admitted neonatal intensive care unit. Conditions associated with preterm birth were low educational attainment, previous history of early neonatal death, maternal low ejection fraction, and abnormal maternal left ventricular geometry. The conditions associated with SGA babies were high gravidity and parity, a history of abortion/stillbirth, a history of previous cesarean section delivery, low ejection fraction, a history of multiple gestations, and higher BMI. CONCLUSION: In this cohort study, adverse maternal outcomes were rarely observed. CVD in pregnancy is associated with an increased risk of preterm birth and SGA babies. We identified certain maternal conditions and sociodemographic factors associated with these outcomes. Despite having CVD, our study cohort had no mortality from the pregnancy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Nacimiento Prematuro Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Asia Idioma: En Revista: J Matern Fetal Neonatal Med Asunto de la revista: OBSTETRICIA / PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Nacimiento Prematuro Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Asia Idioma: En Revista: J Matern Fetal Neonatal Med Asunto de la revista: OBSTETRICIA / PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Reino Unido