Evidence map›Paper›PMID 39277186›Full record

ArticleOpen heart2024

Predictors of spontaneous pregnancy loss in single ventricle physiology.

Yasmine Wazni, Christopher Sefton, Betemariam Sharew, Elizabeth Ghandakly, Patricia Blazevic, Nandini Mehra, Justin R Lappen, Cara D Dolin, Adina Kern-Goldberger, Stephen Bacak and 7 more

Abstract read
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Article in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Yasmine WazniGeorgetown University, Washington, District of Columbia, USA.
Christopher SeftonDepartment of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Betemariam SharewCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Elizabeth GhandaklyDepartment of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Patricia BlazevicUniversity of Toledo College of Medicine, Toledo, Ohio, USA.
Nandini MehraDepartment of Cardiology, Heart Vascular & Thoracic Institute, Cleveland, Ohio, USA.
Justin R LappenDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Cleveland, USA.
Cara D DolinDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Cleveland, USA.
Adina Kern-GoldbergerDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Cleveland, USA.
Stephen BacakDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Cleveland, USA.
Margaret FuchsDepartment of Cardiology, Heart Vascular & Thoracic Institute, Cleveland, Ohio, USA.
Kenneth ZahkaDepartment of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio, USA.
Amy McKenneyDepartment of Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
Larisa G TereshchenkoDepartment of Cardiology, Heart Vascular & Thoracic Institute, Cleveland, Ohio, USA.ORCID 0000-0002-6976-1313
Katherine SinghDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Cleveland, USA.
Peter F AzizDepartment of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio, USA.
Joanna GhobrialDepartment of Cardiology, Heart Vascular & Thoracic Institute, Cleveland, Ohio, USA joannaghobrial@gmail.com.ORCID 0000-0003-2596-1935

Funding

American Heart Association-American Stroke Association 23IPA1054947American Heart Association-American Stroke Association 23TPA1141088
6 · The paper itself

Abstract

backgroundPregnant patients with single ventricle (SV) physiology carry a high risk of spontaneous pregnancy loss (SPL), yet the clinical factors contributing to this risk are not well defined.

methodsSingle-centre retrospective study of pregnant patients with SV physiology seen in cardio-obstetrics clinic over the past 20 years with chart review of their obstetric history. Patients without a known pregnancy outcome were excluded. Univariable Bayesian panel-data random effects logit was used to model the risk of SPL.

resultsThe study included 20 patients with 44 pregnancies, 20 live births, 21 SPL and 3 elective abortions. All had Fontan palliation except for two with Waterston and Glenn shunts. 10 (50%) had a single right ventricle (RV). 14 (70%) had moderate or severe atrioventricular valve regurgitation (AVVR). Atrial arrhythmias were present in 16 (80%), Fontan-associated liver disease (FALD) in 15 (75%) and FALD stage 4 in 9 (45%). 12 (60%) were on anticoagulation. Average first-trimester oxygen saturation was 93.8% for live births and 90.8% for SPL. The following factors were associated with higher odds of SPL: RV morphology (OR 1.72 (95% credible interval (CrI) 1.0008-2.70)), moderate or severe AVVR (OR 1.64 (95% CrI 1.003-2.71)) and reduced first-trimester oxygen saturation (OR 1.83 (95% CrI 1.03-2.71) for each per cent decrease in O2 saturation.

conclusionPregnant patients with SV physiology, particularly those with RV morphology, moderate or severe AVVR, and lower first-trimester oxygen saturations, have a higher risk of SPL. Identifying these clinical risk factors can guide preconception counselling by the cardio-obstetrics team.

Indexed as

Abortion, SpontaneousHeart VentriclesPregnancy Complications, CardiovascularAdultFemaleFontan ProcedureHumansPregnancyRetrospective StudiesRisk AssessmentRisk FactorsUniventricular HeartYoung AdultFontan ProcedureHeart Defects, CongenitalPregnancy

Identifiers

PMID39277186
PMCPMC11428993

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.