Maternal and Neonatal Outcomes in Pregnancies with Cardiovascular Diseases: A Retrospective Cohort Study

Background & Objective: Cardiovascular Disease (CVD) is a significant contributor to maternal morbidity and mortality worldwide. Although pregnancy outcomes in women with cardiac diseases have been described in international registries, data from regional tertiary referral cohorts remain limited. This study was conducted with aim to evaluate maternal and neonatal outcomes among pregnant women with confirmed CVD managed in northeastern Iran.Materials & Methods: In this retrospective cohort study, medical records of ۱۰۳ women with congenital or acquired CVD who delivered between March ۲۰۲۰ and March ۲۰۲۲ at two tertiary hospitals were reviewed. Clinical characteristics, NYHA functional class, and obstetric outcomes were analyzed. Associations between CVD subtype, functional status, and maternal and neonatal outcomes were assessed. Data were analyzed using statistical methods. P< ۰.۰۵ was considered statistically significant.Results: Valvular heart disease was the most common diagnosis (۴۳.۷%). Cesarean delivery occurred in ۵۱.۵% of cases, primary cesarean due to cardiac indications was associated with CVD subtype (P=۰.۰۴۹). Critical care admission (ICU or CCU) was required in ۲۱.۴% of patients. CCU admission was associated with cardiac diagnosis (P=۰.۰۴۳) and higher NYHA class (P=۰.۰۰۳). Maternal mortality occurred in ۱ patient (۱.۰%). Among pregnancies beyond ۲۰ weeks, preterm delivery occurred in ۱۱.۷%. Neonatal outcomes were limited, with intrauterine fetal demise in ۲ cases (۱.۹%) and no association between CVD subtype and neonatal complications. Conclusion: In this tertiary referral cohort, maternal morbidity, particularly critical care need, was associated with cardiac diagnosis and functional status, whereas neonatal complications were limited. These findings underscore the importance of structured risk stratification and multidisciplinary management in pregnancies complicated by CVD.

کلیدواژه ها:

Pregnancy ، cardiovascular diseases ، Pregnancy Complications ، Infant ، Newborn ، Heart Valve Diseases