Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study

Laura Ormesher*, Sarah Vause, Suzanne Higson, Anna Roberts, Bernard Clarke, Stephanie Curtis, Victoria Ordonez, Faiza Ansari, Thomas R Everett, Claire Hordern, Lucy Mackillop, Victoria Stern, Tessa Bonnett, Alice Reid, Suzanne Wallace, Ebruba Oyekan, Hannah Douglas, Matthew Cauldwell, Maya Reddy, Kirsten PalmerMaggie Simpson, Janet Brennand, Laura Minns, Leisa Freeman, Sarah Murray, Nirmala Mary, James Castleman, Katie R Morris, Elizabeth Haslett, Christopher Cassidy, Edward D Johnstone, Jenny E Myers

*Corresponding author for this work

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Abstract

Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fraction < 55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2-7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7-8.2], p = 0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (< 37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, p = 0.03; 15.2% vs. 5.5%, p < 0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal ß blockers (n = 116) were associated with lower birthweight Z score (adjusted difference - 0.31 [95% C.I. - 0.61 to - 0.01], p = 0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the population's background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use.

Original languageEnglish
Article number153
Number of pages14
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusPublished - 4 Jan 2023

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© 2023. The Author(s).

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