PMID- 23044297
OWN - NLM
STAT- MEDLINE
DCOM- 20130308
LR  - 20121009
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 125
IP  - 19
DP  - 2012 Oct
TI  - Risk factors and risk index of cardiac events in pregnant women with heart 
      disease.
PG  - 3410-5
AB  - BACKGROUND: Pregnant women with heart disease are at high risk. Studies of risk 
      factors of these patients are of great significance to improve maternal and fetal 
      outcomes. In this paper, we try to discuss the main risk factors of cardiac 
      events in pregnant women with heart disease and to establish a risk assessment 
      system. METHODS: A retrospective analysis was carried out for pregnancies in 1741 
      women with heart disease who delivered in Shanghai Obstetrical Cardiology 
      Intensive Care Center between January 1993 and September 2010. A Logistic 
      regression model was used to identify independent risk factors of cardiac events 
      and calculate the risk index in pregnant women with heart disease. RESULTS: The 
      composition of heart disease in pregnant women was arrhythmia (n = 662, 38.00%), 
      congenital heart disease (CHD; n = 529, 30.40%), cardiomyopathy (n = 327, 
      18.80%), rheumatic heart disease (RHD; n = 151, 8.70%), and cardiopathy induced 
      by pre-eclampsia (n = 53, 3.00%). Main cardiac events were heart failure (n = 
      110, 6.32%), symptomatic arrhythmia needing medication (n = 43, 2.47%), cardiac 
      arrest (n = 2, 0.11%), syncope (n = 3, 0.17%), and maternal death (n = 10, 
      0.57%). Six independent risk factors to predict cardiac events in pregnant women 
      with heart disease were cardiac events before pregnancy (heart failure, severe 
      arrhythmia, cardiac shock, etc., P = 0.000), New York Heart Association (NYHA) 
      class > II (P = 0.000), oxygen saturation < 90% (P = 0.018), pulmonary artery 
      hypertention (PAH) > 50 mmHg (P = 0.025), cyanotic heart disease without surgical 
      correction (P = 0.015), and reduced left ventricular systolic function (ejection 
      fraction < 40%, P = 0.003). Every risk factor was calculated as 1 score. The 
      incidence of cardiac events in patients with scores 0, 1, 2, 3, and >/= 4 was 
      2.10%, 31.61%, 61.25%, 68.97%, and 100.00% respectively. CONCLUSIONS: Pregnancy 
      with heart disease could lead to undesirable pregnancy outcomes. The risk of 
      cardiac events in pregnant women with heart disease could be assessed by risk 
      index.
FAU - Liu, Hua
AU  - Liu H
AD  - Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong 
      University School of Medicine, Shanghai 200127, China.
FAU - Huang, Tao-Tao
AU  - Huang TT
FAU - Lin, Jian-Hua
AU  - Lin JH
LA  - eng
PT  - Journal Article
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Arrhythmias, Cardiac/epidemiology
MH  - Cardiomyopathies/epidemiology
MH  - Female
MH  - Heart Defects, Congenital/epidemiology
MH  - Heart Diseases/*epidemiology
MH  - Heart Failure/epidemiology
MH  - Humans
MH  - Pre-Eclampsia/physiopathology
MH  - Pregnancy
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2012/10/10 06:00
MHDA- 2013/03/09 06:00
CRDT- 2012/10/10 06:00
PHST- 2012/10/10 06:00 [entrez]
PHST- 2012/10/10 06:00 [pubmed]
PHST- 2013/03/09 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2012 Oct;125(19):3410-5.