The European Heart Journal has published the results of a registry for pregnant women with heart disease. According to the registry, if women receive good prenatal care, counseling on their condition and adequate treatment, heart disease does not pose a threat to pregnancy outcome. However, on the opposite end of the spectrum are women in underdeveloped countries who don’t have access to adequate care, which increases the risk of pregnancy complications, maternal death, and fetal death.

Information for the report was collected between 2007 and 2011 and included participants in nearly 30 countries. The pregnant women in the study suffered from various forms of heart disease with the most common form being congenital heart disease (CHD). CHD is a birth defect that develops in utero, so the impact of the condition affects health and well-being throughout life. However, women in the study with CHD reported better pregnancy outcomes with fewer pregnancy complications, likely because the women learned about the condition before the reproductive years.

Women with cardiomyopathy (CMP) and valvular heart disease (VHD) reported riskier pregnancies. Women with CMP suffered the highest risk of death than women with VHD or CHD. They were also more likely to suffer heart failure. About 2.5% of the women with CHD died during pregnancy compared with just 0.007% of the control group. The heart is permanently damaged from CHD. During pregnancy, increased blood volume and oxygen needs make the heart work harder and if there is already damage there, the risk of death is extremely high.

The researchers expected difference in pregnancy outcomes between the types of heart disease, but other differences had nothing to do with heart disease at all. Women in western cultures with advanced medical care were less likely to suffer pregnancy complications than women in developing nations. Developing nations are less likely to offer prenatal care and educate women with heart disease so they can have a safe, healthy pregnancy.

Much of the information researchers reported in the study was known, but the detailed facts and percentages make it much easier to sort through the groups of women with heart disease to pinpoint the exact women who need extra care and education during pregnancy.

Source: Jolien W. Roos-Hesselink et al. Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology. European Heart Journal. doi:10.1093/eurheartj/ehs270