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Cohort study
Pregnancy-related cardiac risk in women with congenital heart disease: is it over when it's over?
  1. Paul Khairy1,
  2. Susan M Fernandes2,
  3. Michael J Landzberg2
  1. 1Adult Congenital Heart Centre, Montreal Heart Institute, University of Montreal and Boston Adult Congenital Heart Service, Brigham and Women's Hospital and Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Boston Adult Congenital Heart Service, Brigham and Women's Hospital and Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to: Paul Khairy
    Adult Congenital Heart Center, Montreal Heart Institute, 5000 Belanger St East, Montreal, QC, Canada, H1T 1C8; paul.khairy{at}umontreal.ca

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Context

Most women with congenital heart disease can now expect to reach childbearing age. Collectively, congenital malformations are the most common form of heart disease in pregnant women and the leading cardiac cause of maternal morbidity and mortality.1 Over the past two decades, several studies have characterised pregnancy-related changes, assessed maternal and fetal complications and identified related high-risk features. However, risk-stratification attempts have largely focused on acute pregnancy-related complications. Little is known about cardiac outcomes beyond the immediate peripartum setting. It is in this context that Balint and colleagues systematically assessed the frequency and determinants of adverse maternal cardiac events late after pregnancy in women with a broad spectrum of congenital heart malformations.

Methods

A retrospective cohort study included 405 pregnancies in 318 women with congenital heart disease, hypertrophic cardiomyopathy or Marfan syndrome, followed at a tertiary centre in Toronto between …

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