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Long QT syndrome and pregnancy.

Abstract：

OBJECTIVES:This study was designed to investigate the clinical course of women with long QT syndrome (LQTS) throughout their potential childbearing years. BACKGROUND:Only limited data exist regarding the risks associated with pregnancy in women with LQTS. METHODS:The risk of experiencing an adverse cardiac event, including syncope, aborted cardiac arrest, and sudden death, during and after pregnancy was analyzed for women who had their first birth from 1980 to 2003 (n = 391). Time-dependent Kaplan-Meier and Cox proportional hazard methods were used to evaluate the risk of cardiac events during different peripartum periods. RESULTS:Compared with a time period before a woman's first conception, the pregnancy time was associated with a reduced risk of cardiac events (hazard ratio [HR] 0.28, 95% confidence interval [CI] 0.10 to 0.76, p = 0.01), whereas the 9-month postpartum time had an increased risk (HR 2.7, 95% CI 1.8 to 4.3, p < 0.001). After the 9-month postpartum period, the risk was similar to the period before the first conception (HR 0.91, 95% CI 0.55 to 1.5, p = 0.70). Genotype analysis (n = 153) showed that women with the LQT2 genotype were more likely to experience a cardiac event than women with the LQT1 or LQT3 genotype. The cardiac event risk during the high-risk postpartum period was reduced among women using beta-blocker therapy (HR 0.34, 95% CI 0.14 to 0.84, p = 0.02). CONCLUSIONS:Women with LQTS have a reduced risk for cardiac events during pregnancy, but an increased risk during the 9-month postpartum period, especially among women with the LQT2 genotype. Beta-blockers were associated with a reduction in cardiac events during the high-risk postpartum time period.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Seth R,Moss AJ,McNitt S,Zareba W,Andrews ML,Qi M,Robinson JL,Goldenberg I,Ackerman MJ,Benhorin J,Kaufman ES,Locati EH,Napolitano C,Priori SG,Schwartz PJ,Towbin JA,Vincent GM,Zhang L

doi

10.1016/j.jacc.2006.09.054

subject

Has Abstract

pub_date

2007-03-13 00:00:00

pages

1092-8

issue

10

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(06)03118-4

journal_volume

49

pub_type

杂志文章

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