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Mode of delivery among women with maternal cardiac disease

Journal of Perinatology volume 43, pages 849–855 (2023)Cite this article

Subjects

Abstract

Objective

To determine if maternal cardiac disease affects delivery mode and to investigate maternal morbidity.

Study design

Retrospective cohort study performed using electronic medical record data. Primary outcome was mode of delivery; secondary outcomes included indication for cesarean delivery, and rates of severe maternal morbidity.

Results

Among 14,160 deliveries meeting inclusion criteria, 218 (1.5%) had maternal cardiac disease. Cesarean delivery was more common in women with maternal cardiac disease (adjusted odds ratio 1.63 [95% confidence interval 1.18–2.25]). Patients delivered by cesarean delivery in the setting of maternal cardiac disease had significantly higher rates of severe maternal morbidity, with a 24.38-fold higher adjusted odds of severe maternal morbidity (95% confidence interval: 10.56–54.3).

Conclusion

While maternal cardiac disease was associated with increased risk of cesarean delivery, most were for obstetric indications. Additionally, cesarean delivery in the setting of maternal cardiac disease is associated with high rates of severe maternal morbidity.

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Fig. 1: CONSORT diagram of study population.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Funding

AJV received funding through the Eunice Kennedy Shriver National Institute of Child Health & Human Development Building Interdisciplinary Research in Women’s Health (BIRCWH) Award (K12-HD085845) and the Johns Hopkins University School of Medicine Robert E. Meyerhoff Professorship Award. GS is supported by Blumenthal Scholarship In Preventive Cardiology. AM was supported by the National Heart, Lung, and Blood Institute training grant T32HL007024, the Lou and Nancy Grasmick Endowed Research Fellowship and the Marie-Josée and Henry R. Kravis Endowed Fellowship. JJF was supported by the National Center for Advancing Translational Sciences via award TL1TR002555.

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Nicole R. Gavin, Jerome J. Federspiel, Theresa Boyer, Scott Carey, Kristin C. Darwin, Alexia Debrosse & Arthur J. Vaught

  2. Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA

    Jerome J. Federspiel

  3. Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Garima Sharma, Ari Cedars & Anum Minhas

Authors
  1. Nicole R. Gavin
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  2. Jerome J. Federspiel
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  3. Theresa Boyer
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  4. Scott Carey
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  5. Kristin C. Darwin
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  6. Alexia Debrosse
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  7. Garima Sharma
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  8. Ari Cedars
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  9. Anum Minhas
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  10. Arthur J. Vaught
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Contributions

All authors contributed to the conception and design of the study. JF performed the statistical analyses. NG and KD drafted the manuscript and NG, JV and JF revised it. All authors approved the final manuscript.

Corresponding author

Correspondence to Nicole R. Gavin.

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The authors declare no competing interests.

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Gavin, N.R., Federspiel, J.J., Boyer, T. et al. Mode of delivery among women with maternal cardiac disease. J Perinatol 43, 849–855 (2023). https://doi.org/10.1038/s41372-023-01625-4

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