不同类型先天性心脏病女性妊娠结局的回顾性研究OA

Objective To investigate the pregnancy outcomes in women with different types of congenital heart disease(CHD),and its influencing factors.Methods A retrospective study was conducted on the clinical data of 148 pregnant women with CHD who were treated in General Hospital of Northern Theater Command from January 2017 to December 2023.The patients were divided into the simple CHD group(n=64)and the complex CHD group(n=84)according to the type of CHD.The general information,clinical data,and pregnancy outcomes of the patients were collected,the influencing factors of pregnancy outcomes were investigated,and the impact of surgical repair on pregnancy outcomes was analyzed.Results No maternal or neonatal deaths occurred under multidisciplinary team management.The complex CHD group had a higher proportion of patients receiving anticoagulant therapy and a longer hospital stay compared to the simple CHD group(P<0.05).Simple CHD was predominantly left-to-right shunt type in 59 cases(92.19%).Complex CHD types were widely distributed,including left-to-right shunt combined with congenital valvular heart disease in 31 cases(36.90%),isolated congenital valvular heart disease in 23 cases(27.38%),right-to-left shunt in 13 cases(15.48%),and special types in 15 cases(17.86%).Patients in the simple CHD group had a significantly higher proportion of New York Heart Association(NYHA)class Ⅰ than those in the complex CHD group(P<0.05).The incidence of abortion in the simple CHD group was lower than that in the complex CHD group,while the rate of vaginal delivery was higher than that in the complex CHD group,with statistically significant differences(P<0.05).The incidences of pulmonary hypertension and arrhythmia,as well as the rates of preterm birth and low birth weight in the complex CHD group were significantly higher than those in the simple CHD group(P<0.05).Among patients with complex CHD,those without surgical repair had significantly higher risks of developing pulmonary hypertension and preterm birth than those receiving surgical repair.Conclusion Patients with complex CHD have significantly higher risks of cardiac complications and adverse neonatal outcomes during pregnancy compared to those with simple CHD.Surgical repair can reduce the risk of pulmonary hypertension and preterm birth in patients with complex CHD.Multidisciplinary team management is crucial for improving pregnancy outcomes in patients with CHD.