Open this publication in new window or tab >>2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]
Background
Advances in medical treatment during the last 50 years have resulted in more individuals with congenital heart disease (CHD) and Marfan syndrome reaching childbearing age. The substantial physiological changes during pregnancy result in a high-risk situation, and pregnancy is a major concern in women with these conditions.
Aims
- To describe the socio-demographic characteristics, birth characteristics and reproductive patterns of individuals with CHD and women with Marfan syndrome.
- To investigate obstetric and neonatal outcomes in the firstborn children of individuals with CHD and women with Marfan syndrome.
- To study long-term cardiovascular outcomes after childbirth in women with Marfan´syndrome.
Methods
The studies are population-based register studies. The study population in the first paper included all women born between 1973 and 1983 who were alive and resident in Sweden at the age of 13 (494 692 women, of whom 2 216 were women with CHD). In the second paper, the same definition of the study population was chosen, except that it involved all men born between 1973 and 1983 (522 216 men, of whom 2 689 men with CHD). The third and fourth papers involved a study population of all Swedish women born between 1973 and 1993 who were still living in Sweden at age 13. This population consisted of 1 017 538 women, 273 of whom had been diagnosed with Marfan syndrome.
Results and conclusions
The individuals studied were more often born preterm, and were small-for-gestational age babies. They were more likely to have been born by cesarean section. In women with CHD, these characteristics were repeated in their firstborn children. No increased risks were found in children of men with CHD or in children of women with Marfan syndrome. There was no increased risk of aortic dissection in women with Marfan syndrome during pregnancy compared to women with Marfan syndrome who did not give birth. Higher frequencies of cardiac arrhythmia and valvular heart disease were found after childbirth in women with Marfan syndrome. Pregnancy in women with CHD is a high-risk situation associated with increased risk of adverse neonatal outcomes for the expected child. Pregnancy in women without CHD, but where the father has CHD is not so associated with increased risk of adverse obstetric or neonatal outcomes. Pregnancy in women with Marfan syndrome is not associated with adverse outcomes for the expected child.
Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. p. 70
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1565
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology General Practice Pediatrics Clinical Science
Identifiers
urn:nbn:se:liu:diva-134854 (URN)10.3384/diss.diva-134854 (DOI)9789176855713 (ISBN)
Public defence
2017-03-24, Föreläsningssal Eken, Campus US, Linköing, 09:00 (Swedish)
Opponent
Supervisors
2017-02-272017-02-272019-10-28Bibliographically approved