A congenital heart defect (CHD) is the most common type of birth defect. Due to advances in medical and surgical therapies, more than 90% of infants born with a CHD will live to see their 18th birthday.
As dreams of a full and rich adult life—including a career and family—frequently become reality, adolescents and adults should receive specialized cardiology care throughout their lifetime. The impact of a CHD and its interaction with typical conditions of adulthood such as pregnancy, diabetes, and hypertension must be considered as women living with CHD age.
"Young women living with a CHD can expect better outcomes if they partner with their health care team when making health decisions, especially when it comes to reproductive health," said Elyse Foster, M.D., a cardiologist at the University of California, San Francisco, and a member of the Congenital Heart Public Health Consortium (CHPHC).
Anyone who has a heart murmur or had heart surgery as a child should be evaluated by a congenital cardiologist as an adult.
Women living with a CHD, specifically, can make informed choices and decrease their chances of a high-risk birth when they work with their health care team. While the overall risk of complications during pregnancy is relatively low, women with a CHD are still eight times as likely to experience cardiovascular complications during pregnancy.
Reproductive health considerations should start even before a young woman is ready to start a family. These topics should include contraception, the decision to carry a pregnancy, and the challenges of parenting with a CHD. See the articles below for more information on each subject.
"Guidelines and recommendations for care are available for the management of adult patients with congenital heart defects," said Michelle Gurvitz, M.D., a cardiologist at Boston Children's Hospital and a member of the CHPHC. "However, even with the availability of this information, too great a number of patients fall through the cracks in the system." Dr. Gurvitz advocates for a team-based approach to care for her adult patients, including congenital cardiology, primary care and other specialties as needed—including obstetrics, gynecology and psychology.
Additional information regarding congenital heart defects and lifelong cardiac care is available at the CHPHC website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.