Self-rated health in primiparous women with congenital heart disease before, during and after pregnancy – A register study

Abstract

Background. Poor maternal self-rated health in healthy women is associated with adverse neonatal outcomes, but knowledge about self-rated health in pregnant women with congenital heart disease (CHD) is sparse. This study, therefore, investigated self-rated health before, during, and after pregnancy in women with CHD and factors associated with poor self-rated health. Methods. The Swedish national registers for CHD and pregnancy were merged and searched for primiparous women with data on self-rated health; 600 primiparous women with CHD and 3062 women in matched controls. Analysis was performed using descriptive statistics, chi-square test and logistic regression. Results. Women with CHD equally often rated their health as poor as the controls before (15.5% vs. 15.8%, p = .88), during (29.8% vs. 26.8% p = .13), and after pregnancy (18.8% vs. 17.6% p = .46). None of the factors related to heart disease were associated with poor self-rated health. Instead, factors associated with poor self-rated health during pregnancy in women with CHD were ≤12 years of education (OR 1.7, 95%CI 1.2–2.4) and self-reported history of psychiatric illness (OR 12.6, 95%CI 1.4–3.4). After pregnancy, solely self-reported history of psychiatric illness (OR 5.2, 95%CI 1.1–3.0) was associated with poor self-rated health. Conclusion. Women with CHD reported poor self-rated health comparable to controls before, during, and after pregnancy, and factors related to heart disease were not associated with poor self-rated health. Knowledge about self-rated health may guide professionals in reproductive counselling for women with CHD. Further research is required on how pregnancy affects self-rated health for the group in a long-term perspective.

Keywords:

• Self-rated health
• women
• heart defects congenital
• adult congenital heart disease (ACHD)
• pregnancy
• reproductive health
• chronic disease

Ethics statement

The study was approved by the Swedish Ethical Review Authority (Ref: 2020-00701) and adhered to the principles for medical research as described in the Declaration of Helsinki [25]. All women included in the Swedish Pregnancy Register are asked about participation in the register on their first visit in antenatal care.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by Umeå University, the Swedish Heart–Lung Foundation, the Heart Foundation of Northern Sweden, the Swedish Children’s Heart Association, and the Swedish Heart and Lung Association. The funders did not participate in study process or the final manuscript.