AI Article Synopsis
- Understanding the risk profile of obstetric complications in pregnancies with fetal major congenital heart defects (MCHDs) is essential for effective counseling and care.
- This cohort study analyzed data from over 534,000 pregnancies in Denmark between 2008 and 2018, focusing on the link between fetal MCHDs and adverse obstetric outcomes like preeclampsia and preterm birth.
- Results showed that pregnancies with fetal MCHDs had a significantly higher rate of adverse outcomes (22.8%) compared to those without MCHDs (9.0%), highlighting the increased risks associated with these conditions.
Article Abstract
Importance: Understanding the risk profile of obstetric complications in pregnancies with fetal major congenital heart defects (MCHDs) is crucial for obstetric counseling and care.
Objective: To investigate the risk of placenta-related adverse obstetric outcomes in pregnancies complicated by fetal MCHDs.
Design, Setting, And Participants: This cohort study retrieved data from June 1, 2008, to June 1, 2018, from the Danish Fetal Medicine Database, which includes comprehensive data on more than 95% of all pregnancies in Denmark since the database was instituted in 2008. All singleton pregnancies that resulted in a live-born child after 24 weeks' gestation without chromosomal aberrations were included. A systematic search of the literature was performed in PubMed, Embase, and the Cochrane Library from inception to June 1, 2024, to compile existing knowledge and data on adverse obstetric outcomes among MCHD subtypes.
Exposure: Fetal MCHDs including 1 of 11 subtypes.
Main Outcomes And Measures: The primary outcome was a composite adverse obstetric outcome defined as preeclampsia, preterm birth, fetal growth restriction, or placental abruption. Secondary outcomes consisted of each adverse obstetric event. Adjusted odds ratios (AORs) were computed using generalized estimating equations adjusted for maternal body mass index, age, smoking, and year of delivery. Meta-analyses were conducted using random-effects models to pool effect sizes for each MCHD subtype and adverse obstetric outcome.
Results: A total of 534 170 pregnancies were included in the Danish cohort, including 745 with isolated fetal MCHDs (median [IQR] maternal age, 29.0 [26.0-33.0] years) and 533 425 without MCHDs (median [IQR] maternal age, 30.0 [26.0-33.0] years). Pregnancies with fetal MCHDs exhibited a higher rate of adverse obstetric outcomes at 22.8% compared with 9.0% in pregnancies without fetal MCHDs (AOR, 2.96; 95% CI, 2.49-3.53). Preeclampsia (AOR, 1.83; 95% CI, 1.33-2.51), preterm birth at less than 37 weeks (AOR, 3.84; 95% CI, 3.15-4.71), and fetal growth restriction (AOR, 3.25; 95% CI, 2.42-4.38) occurred significantly more frequently in pregnancies with MCHDs. Except for fetal transposition of the great arteries (AOR, 1.19; 95% CI, 0.66-2.15), all MCHD subtypes carried a greater risk of adverse obstetric outcomes. The meta-analysis included 10 additional studies that supported these results.
Conclusions And Relevance: These findings suggest that nearly 1 in 4 women expecting a child with an MCHD, except transposition of the great arteries, may be at high risk of adverse obstetric outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/jamapediatrics.2024.5073 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Surgical Deescalation Within Gynecologic Oncology.
JAMA Netw Open
January 2025
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston.
Importance: The goal of surgical deescalation is to minimize tissue damage, enhance patient outcomes, and reduce the adverse effects often associated with extensive or traditional surgical procedures. This shift toward less invasive techniques has the potential to revolutionize surgical practices, profoundly impacting the methods and training of future surgeons.
Objective: To evaluate adoption of surgical deescalation within the field of gynecologic oncology using The National Cancer Database.
Prevalence and factors associated with female genital mutilation/cutting among Tanzanian women who gave birth in the five years prior to the survey: A population-based study.
PLoS One
December 2024
Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.
Background: Female Genital Mutilation/Cutting (FGM/C) poses a significant public health challenge in developing countries, leading to increased risks of adverse obstetric outcomes such as caesarean section, postpartum hemorrhage, episiotomy, difficult labor, obstetric tears/lacerations, instrumental delivery, prolonged labor, and extended maternal hospital stays. The study aimed to determine the prevalence and factors associated with FGM/C among Tanzanian women who had given birth within five years preceding the Survey.
Method: This study utilized an analytical cross-sectional design based on data from the 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey (TDHS-MIS).
Angiogenic factors versus fetomaternal Doppler for fetal growth restriction at term: an open-label, randomized controlled trial.
Nat Med
January 2025
Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública, Universitat Autònoma de Barcelona, Bellaterra, Spain.
Small fetuses, with estimated fetal weight (EFW) below the tenth percentile, are classified as fetal growth restriction (FGR) or small for gestational age (SGA) based on prenatal ultrasound. FGR fetuses have a greater risk of stillbirth and perinatal complications and may benefit from serial ultrasound scans to guide early delivery. Abnormal serum angiogenic factors, such as the soluble fms-like tyrosine kinase-1 (sFlt-1):placental growth factor (PlGF) ratio, have shown potential to more accurately distinguish FGR from SGA, with fewer false positives.
View Article and Find Full Text PDFIntensity-modulated radiation therapy for early-stage breast cancer: a systematic review and meta-analysis.
Sao Paulo Med J
January 2025
Professor, Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Consultant, Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo (SP), Brazil.
Background: Radiation therapy (RT) is a standard treatment for non-metastatic breast cancer and is associated with acute and late toxicities. Intensity-modulated RT (IMRT) may decrease toxicity and is convenient for patients.
Objectives: To assess the efficacy and safety of IMRT in women with early stage breast cancer.
Effects of different educational interventions on cervical cancer knowledge and human papillomavirus vaccination uptake among young women in Japan: Preliminary results of a cluster randomized controlled trial.
PLoS One
January 2025
Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan.
The incidence and mortality rates of cervical cancer are increasing among young Japanese women. In November 2021, the Japanese Ministry of Health, Labour, and Welfare reinstated the active recommendation of the human papillomavirus (HPV) vaccine, after it had been suspended in June 2013 due to reports of adverse reactions. However, vaccine hesitancy is prevalent in the younger generation in Japan.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!