Uterine rupture and long-term cardiovascular hospitalization of the offspring

BACKGROUND

Uterine rupture is associated with severely adverse maternal and neonatal outcomes. The association between uterine rupture and long-term cardiovascular hospitalization of the offspring has not been investigated yet.

METHODS

In a population-based cohort study, the incidence of cardiovascular related hospitalizations was compared between singletons born to mothers with and without uterine rupture in the current pregnancy. Cardiovascular hospitalization up to the age of 18 years was assessed according to a predefined set of ICD-9 codes associated with offspring hospitalization. Multiple gestations, perinatal deaths, lacking prenatal care, and children with congenital malformations or chromosomal abnormalities were excluded from the study. A Kaplan-Meier survival curve was used to assess cumulative incidence of cardiovascular hospitalization of the offspring. A Cox proportional hazards model was performed to control for confounders.

RESULTS

During the study period, 238,622 newborns met the inclusion criteria, of which 0.053% (n = 127) were born to mothers with uterine rupture in the current pregnancy. Children born to mothers with uterine rupture had significantly higher rates of cardiovascular related hospitalization (Kaplan-Meier's survival curve log-rank test, p=.005).

CONCLUSION

Being born following uterine rupture is an independent risk factor for long-term pediatric cardiovascular hospitalization. Highlights Uterine rupture is a risk factor for long-term pediatric cardiovascular related hospitalization. Rising rate of CS potentially associate to long-term offspring cardiovascular disease. Cardiovascular surveillance is needed for newborns delivered after uterine rupture.

Strengthening information systems for heart health in Canada

Information plays a key role in monitoring, management, evaluation and policy development related to cardiovascular diseases. Canada currently lacks a comprehensive, integrated pan-Canadian system to address the growing burden of cardiovascular diseases, including reliable and timely data that can be used by policy-makers, health care providers, researchers and the public. Theme Working Group 1 (one of six Theme Working Groups) aimed to address different aspects of the Canadian Heart Health Strategy and Action Plan, with a focus on strengthening information systems. Members of the group, who are experts in the cardiovascular field and/or information systems, defined the scope of the issue, identified gaps and solutions, and discussed priorities. The process is described and suggestions for final recommendations are presented. These suggestions were made taking into consideration the needs of health care providers, patients and consumers, the needs for planning, innovation, evaluation and system improvement, and the needs for information on populations and environments. A sustained integrated system that meets cardiovascular information needs requires a major commitment of expertise, leadership and funding.