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Correlation Between Risk or Severity of Heart Failure and Outcome of Pregnancy

Authors Anwar AD, Winarno GNA, Anggraeni EN

Received 30 November 2019

Accepted for publication 28 April 2020

Published 20 May 2020 Volume 2020:13 Pages 201—206

DOI https://doi.org/10.2147/IJGM.S240613

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Anita Deborah Anwar, Gatot NA Winarno, Elsy Nur Anggraeni

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, Indonesia

Correspondence: Anita Deborah Anwar
Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Jl. Pasteur No. 38, Bandung 40161, Jawa Barat, Indonesia
Tel +62 22 203 2530
Fax +62 22 203 9086
Email anitadebbya@yahoo.com

Background: The incidence of heart failure in pregnancy increases by 1– 4% every year and causes 9% of maternal mortality worldwide. Determinant factors, characteristics, and risk factors influence the incidence of heart disease in pregnancy, so the early detection of determinant factors can reduce the incidence of heart disease in pregnancy. This study aimed to find the relationship between determinant factors of maternal and fetal outcomes with the severity of heart disease in pregnancy.
Methods: This was an observational cross-sectional analytical study. We used 342 cases of heart disease in pregnancy that were recorded in medical records at Dr. Hasan Sadikin Hospital, Bandung, Indonesia, from January 2014 to December 2018. The data were grouped based on the severity of heart disease according to the New York Heart Association (NYHA) classification. The relationship of maternal determinant factors with the severity of heart disease was analyzed based on the NYHA classification.
Results: Maternal occupation was significantly associated with a higher risk of NYHA class III–IV heart disease. Most of the patients with NYHA class III-IV were housewives. The severity of heart disease was also influenced by severe preeclampsia (p< 0.05) as a risk factor. Maternal outcome with heart disease of severity NYHA class III–IV was worse than with NYHA class I–II. The risk of maternal death was higher, and the mother’s length of stay in hospital and her need for monitoring were also increased. There were no significant differences in the outcome of the fetus, but the incidence of fetal mortality increased in patients with heart disease severity III–IV.
Conclusion: Maternal determinant factors did not correlate with the severity of heart disease in pregnancy. Maternal outcomes were worse with increasing severity of heart disease. Fetal mortality was correlated with severity of heart disease but other outcomes were not affected.

Keywords: determinant factor, heart disease, maternal and fetal outcomes

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