Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

BJOG. 2010 May;117(6):683-9. doi: 10.1111/j.1471-0528.2010.02512.x. Epub 2010 Feb 15.


Objective: To compare the risks of pregnancy complications in women with repaired and unrepaired isolated ventricular septal defect (VSD).

Design: A retrospective multicentre study.

Setting: Tertiary centres in the Netherlands and Belgium.

Methods: Women were identified using two congenital heart disease registries. Eighty-eight women were identified who had experienced 202 pregnancies, including 46 miscarriages and nine terminations of pregnancy. Information on each completed pregnancy (n = 147; unrepaired VSD, n = 104; repaired VSD, n = 43) was obtained using medical records and telephone interviews. Data from the Generation R database (prospective cohort study; n = 9667) were used to determine the background risk (controls). Odds ratios and 95% CI were estimated using general estimation equation analysis adjusted for multiple pregnancies per woman, maternal age and parity status.

Main outcome measures: Adjusted odds ratios (AORs) for developing pregnancy complications in relation to corrective status.

Results: Pregnancies in women with an unrepaired VSD were associated with a higher risk of pre-eclampsia (AOR 4.59, 95% CI 2.01-10.5, P < 0.001) compared with controls. No differences were observed when comparing women with repaired VSD and controls. Pregnancies in women with repaired VSD were associated with a higher risk of premature labour (AOR 4.02, 95% CI 1.12-14.4, P = 0.03) and small-for-gestational-age (SGA) births (AOR 4.09, 95% CI 1.27-13.2, P = 0.02) compared with women with unrepaired VSD.

Conclusions: Women with unrepaired VSD are at increased risk of pre-eclampsia, which suggests that it is not a benign condition. In addition, women with repaired VSD are at increased risk of premature labour and SGA births compared with women with unrepaired VSD.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Heart Septal Defects, Ventricular / surgery*
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / surgery*
  • Pregnancy Outcome*
  • Premature Birth / etiology
  • Recurrence
  • Retrospective Studies
  • Risk Factors