Effect of maternal age on pregnancy outcome in patients with structural heart disease

Abstract

Objective: To analyze the effect of maternal age on pregnancy outcome in patients with structural heart disease. Methods: Totally 986 patients diagnosed with structural heart disease who had their delivery at Renji Hospital from January 1st, 2003 to December 31st, 2016 were divided into 5 groups according to maternal age. Sixteen (1.6%) were in age group <20 years, 204 (20.7%) were in age group 20-24 years, 461 (46.8%) were in age group 25-29 years, 222 (22.5%) was in age group 30-34 years and 83 (8.4%) was in age group ≥35 years. The incidence of cardiac, obstetric and fetal complications among these groups were analyzed. Results: Among the 986 patients with structural heart disease, 82 (8.3%) experienced adverse cardiac events (some patients had more than 1 complication) , including infective endocarditis (0.4%, 4/986) , malignant arrhythmia (3.3%, 33/986) , heart failure (5.3%, 52/986) , cardiac death (0.9%, 9/986) . The incidence of cardiac complications were respectively 12.5%,11.3%,4.8%,10.4% and 14.5% in each age group, with statistically significant differences when compared with one another (P=0.004) . There was no statistically significant difference in the incidence of obstetric complications (P>0.05) . The incidence of fetal complications in each group showed statistically significant differences (P=0.001) ; which was 25.0%,30.4%,24.1%,29.3% and 47.0% respectively. Conclusions: Age group 25- 29 years presented the lowest risk of cardiac complications and is potentially the optimal age for pregnancy and delivery. Age group <20 or ≥35 years is at higher risk for cardiac complications. The highest rate of fetal complications is in age group ≥35 years.