Photo Credit: Darya Komarova

The following is a summary of “Risk factors for pregnancy-associated heart failure with preserved ejection fraction and adverse pregnancy outcomes: a cross-sectional study,” published in the March 2024 issue of Obstetrics and Gynaecology by Lee et al.

Pregnancy-associated heart failure with preserved ejection fraction (HFpEF) presents a rising concern due to its impact on maternal morbidity, yet its implications for pregnancy remain poorly understood. In this study, the researchers sought to elucidate the risk factors and adverse pregnancy outcomes associated with HFpEF among pregnant women. Through a comprehensive cross-sectional analysis spanning from 2009 to 2020 and drawing from a perinatal database encompassing seven multicenter facilities, the investigators identified cases of HFpEF utilizing the International Classification of Diseases and echocardiography data. Patients were categorized into HFpEF and control groups, with risk factors assessed via multivariate logistic regression analysis, yielding odds ratios (OR) and 95% CI. 

Additionally, adjusted associations between HFpEF and adverse pregnancy outcomes were determined. Notably, HFpEF demonstrated significant associations with advanced maternal age, multiple pregnancies, rheumatic disease, pregnancy-induced hypertension, preeclampsia, eclampsia or superimposed preeclampsia, and transfusion in previous pregnancies. A statistical scoring model incorporating these factors exhibited promising predictive utility for HFpEF, achieving an area under the curve of 0.78 at a cutoff value of 3. Furthermore, women with HFpEF experienced elevated odds ratios for intensive care unit admission during the perinatal period and postpartum hemorrhage. These findings underscore the importance of recognizing pregnancy-associated HFpEF and its potential impact on maternal health, highlighting the value of risk stratification models to facilitate timely intervention and mitigate adverse pregnancy outcomes.

Source: bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06402-5