Karina Niken Pratiwi, MD - UCCVS2016

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.