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A groundbreaking study reveals that major congenital heart defects (MCHDs) in foetuses significantly increase the risk of adverse pregnancy outcomes, including preeclampsia and preterm birth. The research, conducted by the Statens Serum Institut in Copenhagen, emphasizes the critical impact of MCHDs on maternal and neonatal health.
MCHDs, which affect approximately 1 in 100 live births, are linked to complications such as fetal growth restriction and placental abruption, in addition to the heightened risk of preeclampsia and preterm delivery. The study, published in JAMA Pediatrics, analyzed data from 534,170 pregnancies in Denmark, including 745 cases complicated by foetal MCHDs. Only pregnancies resulting in live births after 24 weeks of gestation and without chromosomal abnormalities were included in the research.
Key Findings
- Adverse Outcomes: About 23% of pregnancies with foetal MCHDs resulted in adverse outcomes, compared to significantly lower rates in pregnancies without MCHDs.
- Prevalence of Specific Complications:
- Preterm birth occurred in 15.7% of MCHD pregnancies.
- Preeclampsia was reported in 6.2% of cases.
- Fetal growth restriction affected 6.7% of pregnancies.
- Placental abruption, though rare, was noted in 0.9% of cases, with a significant upward trend.
- Subtype Risks: The highest risks of adverse outcomes were associated with MCHD subtypes such as truncus arteriosus, pulmonary atresia with intact ventricular septum, and Ebstein anomaly. Interestingly, pregnancies involving transposition of the great arteries (TGA) did not show elevated risks for the studied complications.
The study also incorporated a meta-analysis of 5,993 cases of MCHDs, reinforcing the findings and highlighting the variability in risk profiles across different MCHD subtypes.
Implications and Future Directions
This research underscores the urgent need for early diagnosis and targeted interventions to manage pregnancies affected by MCHDs. “Data on the obstetric risk profile for specific MCHD subtypes are limited, which slows the development of preventive measures,” the researchers noted.
By identifying the distinct risks associated with various MCHD subtypes, this study paves the way for more personalized care strategies for expectant mothers and improved outcomes for both mother and child.
Conclusion
With nearly one in four pregnancies involving MCHDs facing complications, this study highlights the significant health burden posed by these conditions. Further research and innovation in prenatal care are essential to mitigate the risks and enhance outcomes for affected families.
