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Congenital heart disease
Original research
Pregnancy outcome in women with atrial septal defect: associated with in vitro fertilisation and pre-eclampsia
  1. Sebastian Udholm1,
  2. Louise Udholm2,
  3. Camilla Nyboe1,
  4. Ulrik Schiøler Kesmodel3 and
  5. Vibeke Elisabeth Hjortdal DMSc, PhD2
  1. 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Cardiothoracic Surgery, Rigshospitalet, Kobenhavn, Denmark
  3. 3Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark
  1. Correspondence to Dr Sebastian Udholm; sebastian.udholm{at}clin.au.dk

Abstract

Objective To investigate in vitro fertilisation (IVF) in women with atrial septal defect (ASD), and to examine the maternal characteristics and outcome of pregnancy, as well as the fetal outcome of infants born by women with ASD.

Methods We used population-based registries in this nationwide cohort study, including Danish individuals born before 1994 who received an ASD diagnosis between 1959 and 2014. Patients were compared with a random reference sample (ratio of 10 citizens per patient) matched by sex and age. The Danish Medical Birth Register (DMBR) contains data on all pregnancies and births in Denmark from 1977 to present. Risk of IVF treatment as well as maternal, pregnancy and fetal outcomes were compared.

Results A total of 2277 Danish patients had a validated ASD diagnosis. Of these, 310 women were identified in the DMBR. Women with ASD had an increased risk of receiving IVF treatment (HR 3.14, 95% CI 2.1 to 4.7, p<0.0001), and a higher proportion of patients received IVF treatment when compared with the reference cohort (10.6% vs 3.2%; p<0.001). Furthermore, patients had more multiple births. Looking at singleton pregnancies (n=519), pre-eclampsia occurred more frequently in patients with ASD during pregnancy (6.7% vs 2.3%; p<0.001). Infants from mothers with ASD were found to have perinatal outcomes comparable to those of infants from the reference group.

Conclusion Women with ASD had an increased risk of and received more IVF treatment than the reference group. The outcome of pregnancy in these patients were generally uneventful, however, we did confirm that pre-eclampsia occurred more frequently.

  • congenital heart disease
  • epidemiology
  • paediatric cardiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/openhrt-2019-001148

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    Footnotes

    • Contributors SU, CN, VH: construction of idea, planning of research, conduct of research, manuscript writing and revision. LU: intellectual and research review, manuscript writing and revision. USK: idea inception and formulation, data interpretation, manuscript writing and revision.

    • Funding This study was funded by Aarhus University and Karen Elise Jensens Foundation.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by The Central Denmark Region Research Committee and the National Board of Health (j.nr. 7-604-04-2/193/KWH).

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.