Maternal and Neonatal Outcomes in Pregnancies Complicated by Heart Disease: A 5-Year Retrospective Study at a Tertiary Center Hospital in Klang Valley, Malaysia

Background: Maternal heart disease is a leading cause of indirect maternal mortality worldwide similarly in Malaysia with substantially increment in heart disease related. Due to enhanced childhood survival rates, an increasing number of women with congenital heart disease are entering their reproductive years, contributing to an expanding high-risk obstetric group.

Aim: To assess the obstetrical and neonatal outcomes among women with maternal heart disease, encompassing both acquired cardiovascular conditions and congenital heart disease.

Materials and Methods: This retrospective cross-sectional study involved pregnant women with heart disease at Hospital Serdang from 2014 to 2018. Maternal sociodemographic information, maternal outcomes, and neonatal outcomes were gathered using a proforma from the hospital registry. Data analysis was conducted using SPSS version 25.0.

Results: A total of 255 cases of heart disease in pregnancy were collected, with 183 (72%) cases being acquired heart diseases and 72 (28%) cases being congenital heart diseases. A significant correlation was noted between the presence of additional medical comorbidities in expectant mothers, the birth weight of infants, and neonatal admission to the intensive care unit in relation to the type of heart disease in pregnancy.

Conclusion: There is a substantial increase in adverse perinatal outcomes. In a rapidly developing country, enhancing the management of pregnant women with heart disease is crucial. This involves improving resources, establishing quality cardiac care facilities, and adopting a collaborative multi-disciplinary team approach. Early cardiac surgical intervention may be beneficial for severe cases, and pre-pregnancy counselling is advised to prevent pregnancy in women with complex diseases, emphasizing the importance of effective contraception for better maternal and neonatal outcomes.