Surgery Before Pregnancy in Women with Congenital Heart Disease: A Retrospective Study.

BACKGROUND: This study aimed to investigate if surgery before pregnancy would result in better maternal and fetal outcomes in patients with congenital heart disease.

METHODS: A retrospective study was conducted using data collected from the medical records of pregnant patients with congenital heart disease, who were seen at Beijing Anzhen Hospital between 2010 and 2019. The patients were divided into surgical and non-surgical groups, and the differences in outcomes were compared.

RESULTS: A total of 999 patients with congenital heart disease (mean age, 28.7±4.3 years) were enrolled, with 403 (40.0%) and 596 (60.0%) in the surgical and non-surgical groups, respectively. The percentages of almost all adverse events were higher in the non-surgical group than in the surgical group. The adverse events included preterm delivery (9.9 vs. 17.1%), low birth weight (6.5 vs. 11.6%), heart failure (2.7 vs. 6.7%), cesarean section (75.7 vs. 85.9%), pulmonary hypertension (13.6 vs. 36.2%), and death (0.5 vs. 2.3%) (all P < 0.05). A total of 16 (1.6%) patients died, including 14 and two in the non-surgical and surgical groups, respectively. Regardless of the type of congenital heart disease, preterm delivery and low birth weight were more common in the non-surgical group compared with the surgical group, and there were no statistical between group differences in the other remaining events.

CONCLUSIONS: In the non-surgical group, the results were similar regardless of the type of congenital heart disease, except for preterm delivery and low birth weight. The overall outcome of the surgical group was better than that of the non-surgical group, and surgery before pregnancy reduced maternal and infant risk.