492
PŮVODNÍ42522701004395143193242296315
PRÁCE75522701004489137177218
Adverse42533701004280117152176206242
obstetric68333701003876105133168195220236266
and96533701003472110
neonatal109133701003773112150185211247263
outcomes137033701003876103133171231266296
of168233701003858
pregnancy17563370100376196135173207245276313
in208633701001452
high-risk21543370100375290128153177193222256
women242633701005291151186224
with26663370100526894133
heart281533701003772107131160
disease29913370100385381117152181217
E423022701004181
|351227010018
VNITŘNÍ4268043010746106127172220280301
LÉKAŘSTVÍ748804301074185130188236280325378400
/11948043010731
Vnitř1270804301074693112140166
Lék.1456804301074083122140
2024;70(3):E4-E91615804301074487129169183224266291333354369411453481525568
/22288043010732
www.casopisvnitrnilekarstvi.cz442680430107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2024.0404254480100376493132161177199218642448010040819974144801001553771151378804480100287389124167204247293316355396414432470516552591609653695741
Adverse4259870275142269395510603707825
obstetric13279870275120249352441558649743807908
and23129870275116244373
neonatal27629870275122241367494616705828894
outcomes37339870275120248338438562749867972
of47829870275120211
pregnancy425124702751232163344635917128419421072
in15741247027560188
high-risk183912470275122188316444542635700804931
women284712470275167290477596724
with364812470275167232321450
heart417512470275123241363456549
disease42515070275123189293412533637756
Juraj4251895013745110152209241
Dubrava1,6881895013776141207250307364422110219030803611371895013729
Monika11881895013793157221252311370
Kaldararova2,15801895013768126156222281323380422486543601217919030803622171895013729
Zuzana22681895013763126179238303361
Niznanska3,26511895013776107159224283347395455514316419030803632001895013729
Miroslav32511895013793124166230277308366423
Korbel3369618950137681291712362953264021190308036
1Department4252056078334562049013373129191244280319410465526561
of1040204901336192
Cardiology,11562049013363116151213238298324384446498515
University16952049013371131156208262298342366402457
Hospital21752049013372132175237262298352377
Bratislava2575204901336095148184208251276328379432
2Department4252206078334582199013373129191244280319410465526561
of1042219901336192
Cardiology,11582199013363116151213238298324384446498515
National16972199013372125160185245306358384
Institute2104219901332687129166191227287323377
for2504219901333292128
Cardiovascular26552199013364117152214239299350403445495554580632667
Diseases3346219901337399141196249291346389
31st425235607833456234901335650523560782548
Department5772349013373129191244280319410465526561
of1161234901336192
Gynecology12762349013371122183238288347373433495547
and18462349013353114175
Obstetrics,20452349013376138181218272308344369418462485
University25532349013371131156209262298342367403457
Hospital30342349013371132175236262298351376
Bratislava3434234901335995148183208251276328379432
Background:4252855012460115161218276316376436496557584
The10392858012150107159
latest1228285801212372106156197231
ESC14902858012149100158
guidelines16792858012156111136193244269293350401441
on21512858012155111
the2293285801213389140
management24632858012184133189238295346431483539573
of3066285801215585
cardiovascular3181285801214594128185209265314363403449505529578612
diseases3823285801215781121172221261313353
during42072858012156112145170226283
pregnancy4520285801215791142200256305361407458
recommend5008285801213384130185270354405462520
estimating425299801215091125149234283316340396453
maternal9082998012183132165216250307356380
cardiovascular1317299801214594128185209265313363403449505529578612
risk195829980121335797145
according2132299801214894139193227284308365422
to2583299801213388
the2700299801213389141
modified28702998012183139198222252279331389
World32882998012184138172197254
Health35712998012166117166191225281
Organization38812998012169103160209265289333384418442498554
(mWHO)44642998012129110193260330358
classification.4851299801214469118158198222252279325375408432488545567
In5447299801212480
contrast,4253138012145100156190223273313348370
there818313801213389141174225
are1067313801214881132
no12223138012156112
validated1357313801214898122146204253286336395
models17753138012183139198249274314
for2112313801212985119
predicting2255313801215690141199224269306330386443
neonatal27213138012156107164221270303353377
and31223138012148104162
obstetric33073138012155113153188238273306331377
risk370731380121335797145
in3875313801212480
these3978313801213389141181233
women.42343138012173129213265321344
Objectives:4253275012472134163218265305334389442487514
To963327801215099
compare1087327801214599184242292325376
the1487327801213490141
neonatal16533278012155107163220269303353377
and20553278012148104162
obstetric22413278012155113154189239273307331377
outcomes26433278012155111145190245329381421
of3089327801215585
pregnancy3198327801215791142200256305361407458
between36813278012157108143220270322379
two40853278012133110165
groups4274327801215690145202259300
of4598327801215585
mothers47083278012183140173230281315356
with5089327801217398132188
heart53023278012155107156189226
disease:425341801215680120171219259310330
women7753418012173128212263319
at1114341801214781
high1214341801215579135191
to1425341801213387
extremely1532341801214997134167217301352377425
high1976341801215579135191
maternal21873418012183131164214248304353377
risk258334180121335797144
(mWHO27463418012128109192258328
III-IV;309334180121244873106133189208
group3321341801215588143199256
1)3597341801215173
and36893418012148104161
women38693418012174128212263320
at4208341801214881
low4309341801212379152
to4480341801213388
intermediate4587341801212479112162195280331388412461494544
maternal51503418012183132165215248304353377
risk42535580121335797145
(mWHO5933558012129110193260330
<9463558012160
III;10293558012124497495
group1147355801215690145201259
2).142935580121527998
Methods:4253695012485141180242302365410438
We8933698012185135
included1059369801212380127152208267319378
4814683698012151106
consecutive16053698012145101158199251298355390414464515
women21513698012174130216268326
with25073698012175100135192
clinically272936980121467095152176223273298323372
significant3132369801214064122179203234262308359416450
congenital36133698012145100158216268325350385435460
heart41043698012156108158192229
diseases,4364369801215782123175225265318359381
valvular4776369801214999124174231256306340
diseases,5147369801215781122174224265317358380
cardiomyopathies,425383801214595128185209265350397452510560593649673725765787
aortic12373838012148104138175199244
diseases,1506383801215681121172221261313353375
or1906383801215589
heart20193838012156107156190227
rhythm2270383801213390136174230314
disorders2608383801215781121177211268320354395
in3028383801212379
a31323838012148
retrospective3205383801213283118151207247304356403439463513563
study.3792383801214075131188237255
We40713838012185133
assessed4229383801214888129180220261312370
pregnancy4624383801215791142199256305361407458
outcomes51063838012155111146190245330381422
in425397801212380
group530397801215690145201259
18153978012151
(19892397801212875122
pregnancies1039397801215791142200256305361407431482523
in1588397801212379
171693397801215195
women,18143978012174129214265322344
with2183397801217499133189
2023973978012152103
live-born252539780121244897147182241297331388
neonates)29393978012155107164220269303353394419
and33843978012148104162
in3572397801212379
group3677397801215689145201259
239623978012151
(354038397801212979129
pregnancies4192397801215791142200256305361407431482523
in4741397801212379
314846397801215198
women,49693978012174129214265322344
with5339397801217398132188
344254118012151104
live-born55241180121244897147181240297331388
neonates).9634118012156107164221270303353394420439
Results:4254255012459114159218248286332359
In807425801212480
group911425801215690145201259
1,1194425801215168
there1286425801213389141175225
was15354258012174123163
a17224258012149
higher1794425801215680137193245278
prevalence2096425801215791142191240264316373419469
of2588425801215585
newborns26974258012156107182240296330387427
with3148425801217498133189
low3361425801212379153
birth3538425801215782115152208
weight37704258012174124149205262295
(50.0%4089425801212878130151203284
vs4397425801214889
2.9%,4509425801215274124206229
p47614258012157
<48424258012160
0.001),4926425801215172125179227249268
a52184258012148
lower5290425801212480154204238
prevalence425439801215791142190240264316372418468
of917439801215585
mature10254398012184133166222256306
newborns13554398012155107181239296330387427
(50.0%1805439801212979130151204285
vs2113439801214889
94.1%,22254398012151105126172246269
p25184398012157
<25984398012160
0.01)2681439801215273125173195
and29004398012148104162
higher3085439801215680137193245278
prevalence3387439801215791142190240264315372418468
of3879439801215485
preterm3987439801215791142176227260345
delivery43564398012156107132156206256290341
(45.0%4720439801212978128149201282
vs5026439801214888
5.9%,5138439801215172122203226
p53884398012157
<54684398012160
0.01).425453801215172124172194213
Newborns6584538012166117191249305339395435
of1113453801215584
group1217453801215689144200258
114954538012151
mothers15654538012184139173229280314355
had19404538012155104161
a21214538012148
significantly2188453801214064120176200230257303352408441465513
lower2721453801212479153203237
birth2977453801215782115151207
weight32044538012173123148204260293
(2442±7533517453801212879128182231291341389438
g39784538012155
vs4053453801214888
3285±45741614538012151100151202260312362411
g,4595453801215677
p46924538012157
<47684538012160
0.0001).4847453801215172125178232280302321
Patients51884538012153101134158209265298339
in425467801212380
group525467801215589145201258
18034678012152
gave8754678012156105152202
birth1097467801215782115152208
significantly1325467801214064120177201231258304354410443468516
earlier1861467801215099133157181232266
than2147467801213390139195
in2362467801212379
group2461467801215690145202259
227404678012152
(35.7±3.12812467801212878128148199255308329375
weeks32074678012173124176224267
vs3494467801214989
38.5±1.336034678012151103125180239283300355
weeks,39784678012174124176224268290
p42884678012157
<43654678012159
0.00001).4444467801215173125179233287335357377
They48414678012149107158206
had50674678012155104162
longer5249467801212379136193245278
hospital4254818012155112152209234268318342
stay795481801213974124171
(13.0±14.0993481801212976121142195256301347369421
days14424818012156105152192
vs1662481801214888
5.0±2.31778481801215172124185238260315
days,21204818012157106152193215
p23634818012156
<24474818012160
0.001),2534481801215172125179227249269
higher2830481801215680137193244278
prevalence3136481801215791141190239264315372418468
of3631481801215585
deliveries37444818012156108133157206256290314366406
per41784818012157109142
Caesarean43484818012158107159199249283334383439
section4814481801214091138174198254311
(100%5153481801212875123177258
vs5439481801214888
63.6%,4254958012151102123176255277
p7224958012157
<7994958012160
0.01),879495801215172124172194214
and11134958012148104162
higher1295495801215579136192243277
estimated1592495801215091125149233282316366424
blood2036495801215782138195253
loss2309495801212379119159
during24884958012157112146170226283
operative27914958012155113165199248282306355405
delivery32164958012156108133156206256289341
(572±1563577495801212878128179239284329381
ml39804958012183107
vs4107495801214889
474±1114216495801215199145204249291333
ml,45714958012183108129
p47204958012157
<47974958012160
0.05).4877495801215172124176203222
We51194958012185134
found5273495801212985141197255
a4255098012148
significantly494509801214064120177201231258304354410443468516
higher1031509801215580136193244278
risk133050980121325797145
of1496509801215485
neonatal16015098012156107164221270303353378
and19995098012149105163
obstetric21825098012155113154189239273307331377
complications2580509801214599184242267291337386420444500557597
of3197509801215585
pregnancies3303509801215791142200256305361407431482523
in3847509801212379
mWHO39475098012183167233304
III-IV427150980121244974108135192
classes4484509801214468117158198249290
vs4794509801214989
pregnancies4904509801215791141199255304361407431482522
in5447509801212480
mWHO4255238012183167233304
<7525238012160
III83652380121244974
classes:934523801214469117158198249290311
delivery12695238012156107132156206256290341
per16345238012157109143
Caesarean18015238012158107158199249282333382439
section2263523801214092138174199255311
(odds2598523801212981140197237
ratio2859523801213383116140196
[OR]3079523801212896151179
22.7,32825238012152103126177189
95%34945238012152103181
confidence3699523801214499156186213271322379425475
interval4197523801212480113164198250299324
[CI]4545523801212884108137
1.3-409.0,4706523801215168123156212265318337389410
p51405238012157
<52215238012159
0.05),5304523801215273125177204224
preterm425537801215791142176226260345
delivery7925378012157108133157206257290342
(OR1156537801212996152
13.1,1330537801215197118164180
95%15335378012151102180
CI1736537801215881
2.4-70.1,1840537801215173126160207257278324341
p22035378012157
<22835378012159
0.01),2365537801215172124173195214
low2602537801212379153
birth2778537801215681115151208
weight30085378012174124149205262295
(OR3325537801212996152
33.0,34995378012152101122175196
95%37175378012151102180
CI3920537801215882
3.8-290.2,4024537801215273126160208259312334388409
p44565378012157
<45355378012160
0.01),4617537801215173125173195215
neonatal48545378012156107164221270303353377
immaturity52545378012123107191240425551801213389123147181232
(OR680551801212996152
16.0,855551801215198120173194
95%10725518012151102181
CI1276551801215882
3.0-85.5,1381551801215172125160214265286340361
p17655518012157
<18455518012159
0.01).1928551801215172125173195214
Conclusion:4255655012460117177224254313359388447507534
Pregnancy980565801215386137195251300356402453
in1454565801212480
women15555658012174129214265322
at1899565801214881
high2002565801215579136192
to2216565801213388
extremely2326565801215098135168219304355380429
high2776565801215680137193
maternal29905658012184133166217251307356381
risk339256580121335898145
(mWHO35595658012128110193259330
III-IV)391056580121244974108135192224
was41555658012174123163
burdened43405658012157113147204255312363422
with4783565801217498133189
a49935658012148
high5063565801215579136193
risk527756580121335797145
of5444565801215485
neonatal4255798012155107164220269303353377
and8305798012148104162
obstetric10205798012155113153188238273306331377
complications.14245798012145100184242267291337387420444500557597619
We20715798012184133
found2232579801212985141198255
significantly2515579801214064120177201231258304354410444468516
worse30595798012173129163204256
obstetric33425798012155113154189239273307331377
and37475798012148104162
neonatal39375798012155107163220269303352377
outcomes43425798012154111145190244329381421
in4791579801212379
pregnancies4898579801215791142199256305361407431482523
in5448579801212480
mWHO4255938012183167233304
classes752593801214569118158198249290
III-IV106559380121244974107134191
than1280593801213389138194
in1497593801212480
mWHO16005938012183167233304
classes1927593801214569118158198249290
<22405938012160
III.23235938012124497496
Key4256105012461113164
words:6106105012475133171232276302
heart9336108012156106154186222
disease,1177610801215679118169217256306326
mWHO15246108012184166231301
classification,1846610801214568116155194217247273318366399422477533553
neonatal24216108012155106161217265298346370
outcomes,28126108012155110143187241324375414435
obstetric32696108012155112151185234268300324369
outcomes,36596108012155110143187241324375414435
pregnancy.4115610801215790140197252300355400450466
Juraj4257401095287094132149
Dubrava,59174010955296140164202237275289
M.D.,89874010956277131143157
Ph.D.,10737401095408297150163177
FESC126774010953774112158
Department42575210955292136174197225291331374398
of84175210954264
Cardiology,92375210954582106149166209227270315352362
University130375210955093109146185209240256282320
Hospital164075210955194124168186211248265
Bratislava192375210954064102126143173190226262299
dubrava.kv@gmail.com42576410954486130155192228265280315354411456522559575592607643685751
Cit.44637407095466388103
zkr:45837407095336792108
Vnitř470874070954183100125149
Lék.487574070953674109125
2024;70(3):E4-E9501874070953977114150163201238260298317330368406432471509
Článek45297527095466399142182216
přijat47627527095456986103139164
redakcí:494375270952462107144178213230243
6.520475270953954
11.52757527095397081
2023537375270953978115154
Článek43887647095466399142182216
přijat46217647095456986103139164
po480276470954488
recenzích:49087647095246299137180214231267310323
8.524976470953954
45321764709539
2024537776470953978115151