Maternal and neonatal factors associated with cesarean delivery in a cohort of pregnancies complicated by prenatally diagnosed congenital heart disease.

Autor: Masters H; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. fryh@ucmail.uc.edu., Marcuccio E; Fetal Heart Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Jukic A; Fetal Heart Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Cnota J; Fetal Heart Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Tabbah S; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Divanovic A; Fetal Heart Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Mar; Vol. 44 (3), pp. 360-365. Date of Electronic Publication: 2023 Aug 14.
DOI: 10.1038/s41372-023-01747-9
Abstrakt: Background: Pregnancies with prenatally diagnosed congenital heart disease (CHD) have increased cesarean delivery (CD) rates, with no outcome improvement.
Objective: We aim to examine indications for delivery, indications for CD and risk factors associated with CD.
Study Design: Retrospective cohort of 322 singleton pregnancies prenatally diagnosed with moderate to severe CHD. We compared maternal and fetal factors correlated with delivery route.
Results: CD rate was 46% (95% CI 40, 51%). Of all CD, 31.3% (95% CI 23.8, 38.7) were secondary to urgent fetal indications. However, 79.7% of inductions resulted in vaginal delivery (VD). Factors associated with CD include morbid obesity (RR 3.0, 95% CI 1.5, 6.1), diabetes (RR 3.9, 95% CI 2.0, 7.3) and severe pre-eclampsia (6.0, 95% CI 1.7, 21.4). Of the 10 most frequent CHD diagnoses, only hypoplastic-left-heart was associated with CD (OR 1.9, 95% CI 1.02, 3.4).
Conclusions: Although the CD rate is higher in fetal CHD, most indications for CD are maternal.
(© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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