Prenatal exposure to isolated amniotic fluid disorders and the risk for long-term cardiovascular morbidity in the offspring

Abstract

Amniotic fluid (AF) abnormalities are often associated with short-term adverse pregnancy outcomes, including cardiovascular-related. We sought to assess whether in utero exposure to AF abnormalities increases the risk for long-term cardiovascular morbidity of the offspring. We examined the incidence of cardiovascular disorders in singletons exposed and non-exposed to isolated oligohydramnios or polyhydramnios. Cardiovascular morbidity was assessed up to the age of 18 years according to a predefined set of ICD-9 codes. A Kaplan–Meier survival curves were used to compare cumulative morbidity incidence. A Cox proportional hazards model was constructed to control for confounders. During the study period, 195,943 newborns met the inclusion criteria, of which 2.0% (n = 4063) were in pregnancies diagnosed with isolated oligohydramnios and 2.9% (n = 5684) in pregnancies with isolated polyhydramnios. Children exposed to isolated AF disorders had significantly higher rates of long-term cardiovascular morbidity (p=.042). Children exposed to isolated oligohydramnios had higher cumulative incidence of cardiovascular morbidity (log-rank test p=.026) compared to unexposed children, opposing to what was demonstrate when comparing polyhydramnios vs. normal AFV (log-rank test p=.749). In the Cox regression model, while controlling for confounders, isolated oligohydramnios were found to be independently associated with long-term cardiovascular morbidity of the offspring.