PMID- 26959402
OWN - NLM
STAT- MEDLINE
DCOM- 20170322
LR  - 20220311
IS  - 1678-4170 (Electronic)
IS  - 0066-782X (Print)
IS  - 0066-782X (Linking)
VI  - 106
IP  - 4
DP  - 2016 Apr
TI  - Risk Prediction of Cardiovascular Complications in Pregnant Women With Heart 
      Disease.
PG  - 289-96
LID - S0066-782X2016005007101 [pii]
LID - 10.5935/abc.20160028 [doi]
AB  - BACKGROUND: Heart disease in pregnancy is the leading cause of non- obstetric 
      maternal death. Few Brazilian studies have assessed the impact of heart disease 
      during pregnancy. OBJECTIVE: To determine the risk factors associated with 
      cardiovascular and neonatal complications. METHODS: We evaluated 132 pregnant 
      women with heart disease at a High-Risk Pregnancy outpatient clinic, from January 
      2005 to July 2010. Variables that could influence the maternal-fetal outcome were 
      selected: age, parity, smoking, etiology and severity of the disease, previous 
      cardiac complications, cyanosis, New York Heart Association (NYHA) functional 
      class > II, left ventricular dysfunction/obstruction, arrhythmia, drug treatment 
      change, time of prenatal care beginning and number of prenatal visits. The 
      maternal-fetal risk index, Cardiac Disease in Pregnancy (CARPREG), was 
      retrospectively calculated at the beginning of prenatal care, and patients were 
      stratified in its three risk categories. RESULTS: Rheumatic heart disease was the 
      most prevalent (62.12%). The most frequent complications were heart failure 
      (11.36%) and arrhythmias (6.82%). Factors associated with cardiovascular 
      complications on multivariate analysis were: drug treatment change (p = 0.009), 
      previous cardiac complications (p = 0.013) and NYHA class III on the first 
      prenatal visit (p = 0.041). The cardiovascular complication rates were 15.22% in 
      CARPREG 0, 16.42% in CARPREG 1, and 42.11% in CARPREG > 1, differing from those 
      estimated by the original index: 5%, 27% and 75%, respectively. This sample had 
      26.36% of prematurity. CONCLUSION: The cardiovascular complication risk factors 
      in this population were drug treatment change, previous cardiac complications and 
      NYHA class III at the beginning of prenatal care. The CARPREG index used in this 
      sample composed mainly of patients with rheumatic heart disease overestimated the 
      number of events in pregnant women classified as CARPREG 1 and > 1, and 
      underestimated it in low-risk patients (CARPREG 0).
FAU - Martins, Luciana Carvalho
AU  - Martins LC
AD  - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
FAU - Freire, Claudia Maria Vilas
AU  - Freire CM
AD  - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
FAU - Capurucu, Carolina Andrade Braganca
AU  - Capurucu CA
AD  - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
FAU - Nunes, Maria do Carmo Pereira
AU  - Nunes Mdo C
AD  - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
FAU - Rezende, Cezar Alencar de Lima
AU  - Rezende CA
AD  - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
LA  - eng
LA  - por
PT  - Journal Article
DEP - 20160308
PL  - Brazil
TA  - Arq Bras Cardiol
JT  - Arquivos brasileiros de cardiologia
JID - 0421031
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Brazil/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Gestational Age
MH  - Heart Diseases/*complications/epidemiology
MH  - Humans
MH  - Logistic Models
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular/epidemiology
MH  - Pregnancy Outcome
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/epidemiology
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Young Adult
PMC - PMC4845701
COIS- Potential Conflict of Interest No potential conflict of interest relevant to this 
      article was reported.
EDAT- 2016/03/10 06:00
MHDA- 2017/03/23 06:00
PMCR- 2016/04/01
CRDT- 2016/03/10 06:00
PHST- 2015/03/30 00:00 [received]
PHST- 2015/11/06 00:00 [accepted]
PHST- 2016/03/10 06:00 [entrez]
PHST- 2016/03/10 06:00 [pubmed]
PHST- 2017/03/23 06:00 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - S0066-782X2016005007101 [pii]
AID - 10.5935/abc.20160028 [doi]
PST - ppublish
SO  - Arq Bras Cardiol. 2016 Apr;106(4):289-96. doi: 10.5935/abc.20160028. Epub 2016 
      Mar 8.