Table 2.
Adverse outcomes associated with maternal congenital heart disease
| Incidence of outcomes | ||
| CHD present | CHD absent | |
| Adverse outcomes | n, % | n, % |
| Severe maternal morbidity excluding transfusion | 1,835 (3.5%) | 499,315 (0.7%) |
| Cardiac severe maternal morbidity | 820 (1.6%) | 152,964 (0.2%) |
| Placental abruption | 900 (1.7%) | 971,841 (1.3%) |
| Preterm delivery | 4,902 (9.5%) | 4,811,147 (6.6%) |
| Preeclampsia and gestational hypertension | 5,264 (10.2%) | 5,563,433 (7.6%) |
| Cesarean delivery | 19,793 (38.2%) | 22,545,517 (30.9%) |
| Postpartum hemorrhage | 2,465 (4.8%) | 2,180,032 (3.0%) |
| Transfusion | 1,062 (2.1%) | 637,974 (0.9%) |
| Stillbirth | 519 (1.0%) | 513,280 (0.7%) |
| Unadjusted models | ||
| Adverse outcomes | RR (95% CI) | RR (95% CI) |
| Severe maternal morbidity excluding transfusion | 5.18 (4.95, 5.42) | 1.0 (reference) |
| Cardiac severe maternal morbidity | 7.56 (7.05, 8.09) | 1.0 (reference) |
| Placental abruption | 1.31 (1.22, 1.39) | 1.0 (reference) |
| Preterm delivery | 1.44 (1.40, 1.48) | 1.0 (reference) |
| Preeclampsia and gestational hypertension | 1.33 (1.30, 1.37) | 1.0 (reference) |
| Cesarean delivery | 1.24 (1.22, 1.25) | 1.0 (reference) |
| Postpartum hemorrhage | 1.59 (1.53, 1.66) | 1.0 (reference |
| Transfusion | 2.35 (2.21, 2.49) | 1.0 (reference) |
| Stillbirth | 1.42 (1.31, 1.55) | 1.0 (reference) |
| Adjusted models | ||
| Adverse outcomes | aRR (95% CI) | aRR (95% CI) |
| Severe maternal morbidity excluding transfusion | 4.97 (4.75, 5.20) | 1.0 (reference) |
| Cardiac severe maternal morbidity | 7.65 (7.14, 8.19) | 1.0 (reference) |
| Placental abruption | 1.30 (1.21, 1.38) | 1.0 (reference) |
| Preterm delivery | 1.47 (1.43, 1.51) | 1.0 (reference) |
| Preeclampsia and gestational hypertension | 1.26 (1.22, 1.29) | 1.0 (reference) |
| Cesarean delivery | 1.20 (1.18, 1.22) | 1.0 (reference) |
| Postpartum hemorrhage | 1.56 (1.50, 1.62) | 1.0 (reference) |
| Transfusion | 2.28 (2.14, 2.42) | 1.0 (reference) |
| Stillbirth | 1.41 (1.30, 1.54) | 1.0 (reference) |
Estimates in the table demonstrate risk in the presence compared to the absence of maternal congenital heart disease. The adjusted models include all the demographic, obstetric, and medical factors in Table 1 including year of delivery, maternal race, maternal age, payer, ZIP code income quartile, pre-gestational diabetes, chronic hypertension, singleton versus multiple gestation, and obesity.