Rates of Reproductive Counseling and Contraception Use in Patients with Heart Failure at a Tertiary Care Center.

BACKGROUND: Increasing numbers of women of childbearing age have cardiac disease including heart failure. In these women, pregnancy can cause significant morbidity and mortality. Contraceptive use and pregnancy counseling in women with heart failure is an essential part of their medical care. Here, we assess contraceptive use and pregnancy counseling of patients with heart failure at a single tertiary care center.

METHODS: This was a retrospective, single-center cohort study of female patients with heart failure with reduced ejection fraction, LVADs, and heart transplants who were seen in the adult Advanced Heart Failure outpatient clinics. Patients were identified in the electronic health-care record system, and records were reviewed to assess for documentation of contraception and pregnancy counseling.

RESULTS: We identified 156 women of childbearing age, age >18 to <45, seen in the heart failure clinics between 2018-2023. Patients were sub-divided by their most recent diagnosis/therapy: heart failure with reduced ejection fraction (83, 53.2%), LVAD (18, 11.5%), and heart transplant (55, 35.3%). Contraception was documented for 74% of women with heart failure, 56% of women with LVAD, and 85% of women with heart transplants. Pregnancy counseling was documented for 18% of women with heart failure, 0.06% of women with LVAD, and 29% of women with heart transplants.

CONCLUSIONS: In our study, many women with heart failure, LVAD, or transplant have documented contraceptive therapy, however pregnancy counseling appears to be limited. This vital aspect of medical care should be available for all patients given potential pregnancy-associated risks.