Alrifai N, Alhuneafat L, Jabri A, Khalid MU, Tieliwaerdi X, Sukhon F, Hammad N, Al-Abdouh A, Mhanna M, Siraj A, Sharma T. Pregnancy and Fetal Outcomes in Patients with Ehlers-Danlos Syndrome: A Nationally Representative Analysis.
Curr Probl Cardiol 2023;
48:101634. [PMID:
36806636 DOI:
10.1016/j.cpcardiol.2023.101634]
[Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION
Cardiovascular (CV) disease remains one of the leading causes of maternal morbidity and mortality globally. CV complications occur frequently in Ehlers-Danlos Syndrome (EDS). Pregnancy outcomes, however, are not well established in patients with EDS. We aim to evaluate pregnancy outcomes in this population compared to patients without EDS.
METHODS
We conducted a population-based, retrospective, cohort study using the national inpatient data sample to evaluate and compare pregnancy and fetal outcomes in patients with and without EDS, delivering between 2016 and 2019. Regression analysis was performed and adjusted for maternal age and race to compare maternal and fetal outcomes.
RESULTS
Of the total 5,887,050 births in our cohort, 1,016 were to patients with EDS. The EDS cohort was more likely to be older and white with multiple gestations and comorbidities, such as smoking, mitral valve prolapse, and chronic hypertension. When we adjusted for age and race, patients with EDS were more likely than those without EDS to require Cesarean-section, develop postpartum hemorrhage, experience intrauterine growth restriction, and deliver preterm.
CONCLUSION
In this nationally representative study, patients with EDS experienced higher rates of maternal complications, however, aortic aneurysmal rupture was not among them. Further studies regarding each type of EDS and its obstetric complications may aid in pre-pregnancy counseling, antenatal care, and formulating a multidisciplinary obstetric approach for this patient population.
SHORT ABSTRACT
Cardiovascular complications occur frequently in Ehlers-Danlos Syndrome (EDS). Pregnancy outcomes, however, are not well established in patients with EDS. We conducted a population-based, retrospective, cohort study using the national inpatient sample to compare pregnancy and fetal outcomes in patients with and without EDS, delivering between 2016 and 2019. Regression analysis was performed and adjusted for maternal age and race to compare both groups. Of the total 5,887,050 births in our cohort, 1,016 were to patients with EDS. The EDS cohort was more likely to be older, white and have multiple comorbidities, such as smoking, mitral valve prolapse, and chronic hypertension. When we adjusted for age and race, patients with EDS were more likely than those without EDS to require Cesarean-section, develop postpartum hemorrhage, experience intrauterine growth restriction, and deliver preterm. In this study, patients with EDS experienced higher rates of maternal complications, however, aortic aneurysmal rupture was not among them.
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