Cardiac and Obstetric Outcomes Associated With Mitral Valve Prolapse
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology; Division of Cardiovascular Medicine, Department of Medicine; Department of Population and Quantitative Health Sciences
Cardiology | Cardiovascular Diseases | Epidemiology | Maternal and Child Health | Obstetrics and Gynecology
Mitral valve prolapse (MVP) is the most common valvular heart disease in women of reproductive age. Whether MVP increases the likelihood of adverse outcomes in pregnancy is unknown. The study objective was to examine the cardiac and obstetric outcomes associated with MVP in pregnant women. This retrospective cohort study, using the Healthcare Cost and Utilization Project National Readmission Sample database between 2010 and 2017, identified all pregnant women with MVP using the International Classification of Disease, Ninth and Tenth Revisions codes. The maternal cardiac and obstetric outcomes in pregnant women diagnosed with MVP were compared with women without MVP using multivariable logistic and Cox proportional hazard regression models adjusted for baseline demographic characteristics. There were 23,000 pregnancy admissions with MVP with an overall incidence of 16.9 cases per 10,000 pregnancy admissions. Pregnant women with MVP were more likely to die during pregnancy (adjusted hazard ratio 5.13, 95% confidence interval [CI] 1.09 to 24.16), develop cardiac arrest (adjusted odds ratio [aOR] 4.44, 95% CI 1.04 to 18.89), arrhythmia (aOR 10.96, 95% CI 9.17 to 13.12), stroke (aOR 6.90, 95% CI 1.26 to 37.58), heart failure (aOR 5.81, 95% CI 3.84 to 8.79), or suffer a coronary artery dissection (aOR 25.22, 95% CI 3.42 to 186.07) compared with women without MVP. Pregnancies with MVP were also associated with increased risks of preterm delivery (aOR 1.21, 95% CI 1.02 to 1.44) and preeclampsia/hemolysis, elevated liver enzymes, and low platelets syndrome (aOR 1.22, 95% CI 1.05 to 1.41). In conclusion, MVP in pregnancy is associated with adverse maternal cardiac outcomes and higher obstetric risks.
DOI of Published Version
Wilkie GL, Qureshi WT, O'Day KW, Aurigemma GP, Goldberg RJ, Amjad W, Alqalyoobi S, Kakouros N, Lauring JR, Leftwich HK, Harrington CM. Cardiac and Obstetric Outcomes Associated With Mitral Valve Prolapse. Am J Cardiol. 2022 Jan 1;162:150-155. doi: 10.1016/j.amjcard.2021.09.014. Epub 2021 Oct 22. PMID: 34689956. Link to article on publisher's site
The American journal of cardiology
Wilkie GL, Qureshi W, O'Day K, Aurigemma GP, Goldberg R, Amjad W, Alqalyoobi S, Kakouros N, Lauring JR, Leftwich HK, Harrington CM. (2021). Cardiac and Obstetric Outcomes Associated With Mitral Valve Prolapse. Population and Quantitative Health Sciences Publications. https://doi.org/10.1016/j.amjcard.2021.09.014. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1460