Abstract

Objectives

Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts.

Methods

This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with structurally abnormal hearts, we identified women with an arrhythmic event and randomly subsampled the rest of the cohort to create a control group of 1025 patients. Multivariate analysis was performed to examine the association between arrhythmias and the incidence of caesarean section (CS), preterm labour (PTL), admission to the neonatal intensive care unit and longer length of stay (LOS).

Results

Of 1 41 769 women admitted in labour with a structurally normal heart, 137 had at least one arrhythmic event (0.097%). Supraventricular tachycardia (SVT), atrial fibrillation/flutter (AF) and frequent premature ventricular complexes or non-sustained ventricular tachycardia (VA) were present in 65 (0.046%), 22 (0.016%) and 46 (0.032%) women, respectively. Arrhythmia was previously diagnosed in 58.0% SVT cases but only in 9.7% AF and 8.1% VA cases. After adjusting for age, parity and comorbidities, the presence of any arrhythmia was an independent predictor of CS (OR 1.7 95% CI 1.2 to 2.5), PTL (OR 1.8, CI 1.1 to 3.0) and LOS (mean ratio 1.6, CI 1.4 to 1.8). This association was driven by presence of SVT and AF, whereas VAs were not associated with adverse outcomes.

Conclusions

Arrhythmias, specifically SVT and AF, during labour in women with structurally normal heart are independently associated with adverse obstetrical outcomes.

Details

Title
Prevalence and clinical significance of arrhythmias during labour in women with structurally normal hearts
Author
Sharma, Nikhil 1 ; Coleman, Kristie 1   VIAFID ORCID Logo  ; Ma, Rosaline 1 ; Dillon Gurciullo 2 ; Tia Bimal 1 ; Ansari, Umair 1 ; Wolf, Elliot 1 ; Liu, Yan 3 ; Hentz, Roland 3 ; Mountantonakis, Stavros E 4 

1  Department of Cardiology, Lenox Hill Hospital, New York City, New York, USA 
2  Department of Obstetrics & Gynecology, Lenox Hill Hospital, New York City, New York, USA 
3  Quantitative Intelligence, Feinstein Institutes for Medical Research, Manhasset, New York, USA 
4  Lenox Hill Hospital, New York City, New York, USA 
First page
e002117
Section
Arrhythmias and sudden death
Publication year
2022
Publication date
2022
Publisher
BMJ Publishing Group LTD
ISSN
2398595X
e-ISSN
20533624
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1136/openhrt-2022-002117
ProQuest document ID
2724395953
Copyright
© 2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.