PDF(Pubmed)
Abstract：
BACKGROUND: The impact of hypertrophic cardiomyopathy (HCM) on cardiovascular and obstetrical outcomes in pregnant women remains unclear, particularly in Asian populations. This study aimed to evaluate the maternal cardiovascular and obstetrical outcomes in Korean women with HCM.
METHODS: Using data from the Korean National Health Insurance Service database, we identified women who gave birth via cesarean section or vaginal delivery after being diagnosed with HCM between 2006 and 2019. Maternal cardiovascular and obstetrical outcomes were assessed based on the trimester of pregnancy.
RESULTS: This study included 122 women and 158 pregnancies. No maternal deaths were noted; however, 21 cardiovascular events, such as hospital admission for cardiac problems, including heart failure and atrial fibrillation (AF), new-onset AF or ventricular tachycardia (VT) occurred in 14 pregnancies (8.8%). Cardiac events occurred throughout pregnancy with a higher occurrence in the third trimester. Cesarean sections were performed in 49.3% of the cases, and all cardiovascular outcomes occurring after delivery were observed in patients who had undergone cesarean sections. Seven cases involved preterm delivery, and two of these cases were accompanied by cardiac events, specifically AF. Pre-existing arrhythmia (AF: odds ratio (OR): 7.44, 95% confidence interval (CI): 2.61-21.21, P < 0.001; VT: OR: 31.61, 95% CI: 5.85-172.77, P < 0.001) was identified as a predictor for composite outcomes of cardiovascular events or preterm delivery.
CONCLUSIONS: Most pregnant women with HCM were well-tolerated. However, cardiovascular complications could occur in some patients. Therefore, planned delivery may be necessary for selected patients, especially the women with pre-existing arrhythmias.
METHODS: Using data from the Korean National Health Insurance Service database, we identified women who gave birth via cesarean section or vaginal delivery after being diagnosed with HCM between 2006 and 2019. Maternal cardiovascular and obstetrical outcomes were assessed based on the trimester of pregnancy.
RESULTS: This study included 122 women and 158 pregnancies. No maternal deaths were noted; however, 21 cardiovascular events, such as hospital admission for cardiac problems, including heart failure and atrial fibrillation (AF), new-onset AF or ventricular tachycardia (VT) occurred in 14 pregnancies (8.8%). Cardiac events occurred throughout pregnancy with a higher occurrence in the third trimester. Cesarean sections were performed in 49.3% of the cases, and all cardiovascular outcomes occurring after delivery were observed in patients who had undergone cesarean sections. Seven cases involved preterm delivery, and two of these cases were accompanied by cardiac events, specifically AF. Pre-existing arrhythmia (AF: odds ratio (OR): 7.44, 95% confidence interval (CI): 2.61-21.21, P < 0.001; VT: OR: 31.61, 95% CI: 5.85-172.77, P < 0.001) was identified as a predictor for composite outcomes of cardiovascular events or preterm delivery.
CONCLUSIONS: Most pregnant women with HCM were well-tolerated. However, cardiovascular complications could occur in some patients. Therefore, planned delivery may be necessary for selected patients, especially the women with pre-existing arrhythmias.
摘要：
背景：肥厚型心肌病（HCM）对孕妇心血管和产科结局的影响尚不清楚，特别是在亚洲人群中。本研究旨在评估韩国女性HCM患者的母体心血管和产科结局。
方法：使用韩国国民健康保险服务数据库中的数据，我们确定了在2006年至2019年间诊断为HCM后通过剖宫产或阴道分娩的女性.根据妊娠三个月评估产妇的心血管和产科结局。
结果：这项研究包括122名妇女和158名孕妇。没有发现孕产妇死亡；然而，21心血管事件，比如因心脏问题入院，包括心力衰竭和心房颤动（AF），14例妊娠患者(8.8%)发生新发房颤或室性心动过速(VT).心脏事件发生在整个妊娠期间，妊娠晚期的发生率更高。49.3%的病例进行了剖宫产,观察剖宫产患者分娩后发生的所有心血管结局.七例涉及早产，其中两例伴有心脏事件，特别是AF。预先存在的心律失常（AF：比值比（OR）：7.44，95％置信区间（CI）：2.61-21.21，P<0.001；VT：OR：31.61，95％CI：5.85-172.77，P<0.001）被确定为心血管事件或早产复合结局的预测因子。
结论：大多数HCM孕妇的耐受性良好。然而,一些患者可能发生心血管并发症。因此,计划分娩可能对选定的患者是必要的，尤其是先前有心律失常的女性。
方法：使用韩国国民健康保险服务数据库中的数据，我们确定了在2006年至2019年间诊断为HCM后通过剖宫产或阴道分娩的女性.根据妊娠三个月评估产妇的心血管和产科结局。
结果：这项研究包括122名妇女和158名孕妇。没有发现孕产妇死亡；然而，21心血管事件，比如因心脏问题入院，包括心力衰竭和心房颤动（AF），14例妊娠患者(8.8%)发生新发房颤或室性心动过速(VT).心脏事件发生在整个妊娠期间，妊娠晚期的发生率更高。49.3%的病例进行了剖宫产,观察剖宫产患者分娩后发生的所有心血管结局.七例涉及早产，其中两例伴有心脏事件，特别是AF。预先存在的心律失常（AF：比值比（OR）：7.44，95％置信区间（CI）：2.61-21.21，P<0.001；VT：OR：31.61，95％CI：5.85-172.77，P<0.001）被确定为心血管事件或早产复合结局的预测因子。
结论：大多数HCM孕妇的耐受性良好。然而,一些患者可能发生心血管并发症。因此,计划分娩可能对选定的患者是必要的，尤其是先前有心律失常的女性。
