A survey of women born in Sweden has revealed three significant links between being born prematurely and having an inborn heart defect, what doctors call congenital heart disease (CHD). First, women with CHD were more likely to have been born preterm or small-for-gestational age (SGA) than women without CHD. Secondly, when women with CHD have children, their babies are more likely to have a congenital malformation than children of unaffected women. They are also more prone to give birth to children preterm or SGA and their babies are more often delivered by cesarean section. And thirdly, mothers of women with CHD were more often single/unmarried or older than mothers whose children did not have heart disease. These findings were published today in AOGS (Acta Obstetricia et Gynecologica Scandinavica), the Nordic journal of obstetrics, gynecology and reproductive health.

The complex set of findings was revealed when a team of researchers reviewed data that had been collected from women who have been born in Sweden between 1973 and 1983. From this group they selected women who were still alive and living in Sweden and had had a least one child. This gave them a group of 188 867 women, who they could study to see whether they had CHD.

CHDs are the most common congenital abnormality, with between 5 and 8 per 1000 live-born infants having some form of CHD.

In previous research, data from women with CHD have been grouped together with women who were born with healthy hearts, but who picked up a heart disease during their lives. As a result it has been difficult to see just how much influence CHD really had on a woman's offspring. "This, however, is the first time anyone has used data from a large national cohort to compare mothers with CHD with all other women," says senior consultant in obstetrics Associate Professor Ann Josefsson, who led the study that was carried out at the Faculty of Health Sciences in Linköping University, Sweden.

While the results are somewhat worrying for women with CHD, Dr. Josefsson believes that these women should not be discouraged from seeking to have children. "But they should be offered prenatal diagnostics as there is an increased risk for congenital abnormalities and multiprofessional antenatal care," she says.

There are many different types of congenital heart disease, so our next step in this research is to see how the risks for pregnancy and outcome vary between the various types.

Full citation:
"Reproductive patterns and pregnancy outcomes in women with congenital heart disease - a Swedish population-based study."
Josefsson et al.
Acta Obstetricia et Gynecologica Scandinavica.