Pregnancies with prenatally diagnosed congenital heart disease (CHD) have increased cesarean delivery (CD) rates, with no outcome improvement.
We aim to examine indications for delivery, indications for CD and risk factors associated with CD.
Retrospective cohort of 322 singleton pregnancies prenatally diagnosed with moderate to severe CHD. We compared maternal and fetal factors correlated with delivery route.
CD rate was 46% (95% CI 40, 51%). Of all CD, 31.3% (95% CI 23.8, 38.7) were secondary to urgent fetal indications. However, 79.7% of inductions resulted in vaginal delivery (VD). Factors associated with CD include morbid obesity (RR 3.0, 95% CI 1.5, 6.1), diabetes (RR 3.9, 95% CI 2.0, 7.3) and severe pre-eclampsia (6.0, 95% CI 1.7, 21.4). Of the 10 most frequent CHD diagnoses, only hypoplastic-left-heart was associated with CD (OR 1.9, 95% CI 1.02, 3.4).
Although the CD rate is higher in fetal CHD, most indications for CD are maternal.
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The datasets generated during the current study are available from the corresponding author on reasonable request.
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The authors declare no competing interests.
The study was performed in accordance with the Declaration of Helsinki. This study was approved by the institutional review board at Cincinnati Children’s Hospital Medical Center (IRB# 2019-0739) and University of Cincinnati Medical Center (IRB #2020-040).
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Masters, H., Marcuccio, E., Jukic, A. et al. Maternal and neonatal factors associated with cesarean delivery in a cohort of pregnancies complicated by prenatally diagnosed congenital heart disease. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01747-9