Doctors often advise them not to attempt pregnancy because of the risks of dying and other health problems for both mothers and babies.
The current study analysed 7,512 pregnancies in 4,015 women with CHD in Germany investigated the issue and shows that no women died, although there were more health complications for these mothers and babies compared to a control group of 11,225 pregnancies in 6,502 women without CHD.
The most important finding from this study is that many women born with a congenital heart defect are able to get through pregnancy and give birth safely.
“This is important because only a few decades ago many women would not even have reached adult age themselves. It is very encouraging to see that such a large number of mothers with a congenital heart defect can give birth to healthy children,” said Dr Astrid Lammers, who is the first author of the study and a consultant in paediatric cardiology at University Hospital Münster, Germany.
There are health problems around the time of birth, which are relevant and important. However, the advanced neonatal support and techniques can handle these problems.
Although complications were low overall, women with CHD had a significantly higher rate of stroke, heart failure, and abnormal heart rhythm problems compared to women without CHD.Caesarean deliveries were also more common in CHD patients.
Among babies born to mothers with CHD, there was an increased risk of stillbirths, death within the first month of life, being premature, requiring mechanical ventilation, having major visible abnormalities, and Down’s syndrome or other genetic syndromes.
18% percent of babies born to mothers with CHD had CHD themselves, and 6% needed heart surgery with heart-lung machine support by the age of six years.
Researchers also point out that the mothers they studied were in a well-funded, decentralised health system where they would have had access to appropriate counselling. The same results would be unlikely in less well-resourced countries.
They hope these findings should help to inform mothers-to-be with congenital heart disease what to expect in terms of neonatal complications and to direct them to appropriate care providers if they wish to start a family.
Counselling is a very important part of the care of every woman with a congenital heart defect and should start at an early age to avoid very high-risk pregnancies and appropriate management of pregnancy.
Health problems seem to occur mainly in the offspring and so counselling should focus on the potential health problems for them.
Sometimes the desire to have a child outweighs these risks and women still choose to get pregnant. In this case, it’s important to provide close medical supervision by all the specialists involved throughout the whole course of the pregnancy.
The pregnancy outcomes in studies with a global perspective, including patients from developing countries, show less favourable results.
These differences illustrate how the health care system and environment of women have great impact on their pregnancy outcomes and show that more importance should be given to improve these outcomes for all women worldwide.
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