The burden of premature ventricular contractions predicts adverse fetal
and neonatal outcomes among pregnant women without structural heart
disease: a prospective cohort study
Abstract
Objective: To investigate the outcomes of fetuses or neonates of
pregnant women with premature ventricular contractions (PVCs). Design:
Prospective cohort study. Setting: University-affiliated tertiary
hospital. Population: 6, 148 pregnant women with normal cardiac
structure and function and 103 with a PVC burden >0.5%
among them. Methods: 103 pregnant women with PVCs were divided into two
groups based on the presence or absence of adverse fetal or neonatal
events. The adverse outcomes were compared between the groups. Main
outcome measures: Adverse fetal and neonatal events: premature birth
(<37 weeks gestation), small-for-gestational-age birth weight
(<10th percentile for gestational age or <2500 g),
respiratory distress syndrome, intraventricular hemorrhage and fetal
death (after 20 weeks gestation and before birth). Results: A total of
17 adverse events (12 cases) occurred among 103 pregnant women with
PVCs, which was significantly higher than that among women without PVCs
(11.65% vs. 2.93%, p<0.01). Compared with that of the women
without adverse events, the median PVC burden of women with adverse
fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%,
p<0.01). Multivariate logistic regression analysis
demonstrated that PVC burden was associated with adverse fetal or
neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI
(1.11-1.61), p<0.01). Conclusions: Frequent PVCs have adverse
effects on pregnancy, and the PVC burden might be an important factor
associated with adverse fetal and neonatal outcomes among pregnant women
with PVCs. Our cohort study indicated that the higher the PVC burden is,
the higher the likelihood of adverse events would be.