Risk factors of perinatal complications in patients with pulmonary hypertension underwent cesarean section in 4 Chinese centers.
10.3760/cma.j.cn112148-20211202-01041
- Author:
Jun ZHANG
1
;
Wei Da LU
2
;
Min LI
3
;
Guo LI
4
;
Hua FENG
5
;
Hong Yu ZHANG
2
;
Qiu Shang JI
6
;
Xiao Pei CUI
2
Author Information
1. Department of Cardiovascular Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
2. Department of Geriatric Medicine & Shandong Key Laboratory Cardiovascular Proteomics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
3. Intensive Care Unit of Cardiac Surgery, Shandong Provincial Qianfoshan Hospital, First Hospital Affiliated to Shandong First Medical University, Affiliated Hospital of Shandong University, Jinan 250014, China.
4. Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China.
5. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
6. Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
- Publication Type:Journal Article
- MeSH:
Cesarean Section/adverse effects*;
China/epidemiology*;
Female;
Humans;
Hypertension, Pulmonary/epidemiology*;
Pregnancy;
Pregnancy Outcome;
Retrospective Studies;
Risk Factors
- From:
Chinese Journal of Cardiology
2022;50(1):43-48
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To identify the risk factors related to perinatal complications in patients with pulmonary hypertension underwent cesarean section. Methods: We retrospectively analyzed the medical records of all pregnant women with pulmonary hypertension hospitalized in 4 different hospitals in Shandong province and underwent cesarean section between May 2010 and May 2020. Patients were divided into perinatal complication group and control group according to the presence or absence of perinatal complications. Perinatal complications included aggravated heart function, new onset arrythmias, sudden cardiac arrest, all-cause death within 42 days post cesarean section, postpartum bleeding and thrombotic events. Risk factors of perinatal complications were analyzed. Results: A total of 167 patients (47 cases in the perinatal complication group and 120 cases in the control group) were included in this study. The average age of this cohort was 28(24, 32) years, and 75(44.9%) patients suffered newly diagnosed pulmonary hypertension during pregnancy. The main cause of pulmonary hypertension was congenital heart disease (137(82.0%)). Age, pregnant weeks, percent of primipara, intra-cardiac shunt, and receiving targeted medication therapy, cardiac dimensions were similar between the two groups. A total of 62 complications were recorded in the complication group including 28 cases of aggravated heart function, 4 cases of new onset arrythmias, 2 cases of cardiac arrest, 11 cases of bleeding or thrombotic events and 17 patients were dead. Prevalence of idiopathic pulmonary hypertension and general anesthesia was significantly higher, functional capacity was significantly lower in perinatal complication group than in control group (all P<0.05). The estimated systolic pulmonary artery pressure, serum N-terminal pro-B type natriuretic peptide and total bilirubin (TBIL) levels were significantly higher in perinatal complication group than in control group (all P<0.05). Logistic analysis demonstrated WHO Function Class(FC) Ⅲ/Ⅳ (OR=2.416,95%CI 1.016-5.743, P=0.046) and TBIL level (OR=6.874,95%CI 1.643-28.757, P=0.008) were the independent risk factors of perinatal complications. Conclusion: TBIL and WHO FC are independent risk factors of perinatal complications in pregnant women with pulmonary hypertension underwent cesarean section.
