The Late Effects of Pregnancy on Ascending Aortic Dimensions in Patients with Marfan Syndrome

Background and aim:

While the immediate effects of pregnancy in patients with Marfan syndrome (MS) have been evaluated, the late effects of subsequent pregnancies in these patients are less known.

For this purpose we retrospectively evaluated the changes in ascending aortic dimensions over time in women with MS who underwent pregnancy compared with women with MS who did not experience pregnancy.

Methods:

Two groups of women with MS who were under care in our institution were compared. Group A included 19 women with MS who experienced 44 pregnancies, Group B included 19 patients with MS who never got pregnant. Eight women who underwent surgery before their first visit to our hospital and one patient, who developed post-partum type A dissection and underwent a Bentall procedure were excluded from the study.

Results:

When compared with the patients in group B, patients in group A were older (37.8±4.9 vs.33±7 years, p=0.02) with longer follow-up time (6.4±2.8 vs 3.8±2.9 years). The mean number of pregnancies per woman was 2.3 (range 1-6 pregnancies). Baseline aortic diameters as well as the aortic diameters at the end of the follow up period were similar between groups (37±5 vs 33±9 mm and 38±5 vs 35±5 mm respectively, p-ns for both). The aortic diameter increased by 1.7±3 mm in group A and 1.9±3 mm in group B (p=0.9). The percentual change in diameter was similar in both groups (5±8% in group A vs. 5±7% in group B, p=0.9) .Chronic medical treatment was similar in both groups (11 patients in each group).

Conclusions:

Patients with MS who underwent pregnancies were older and had a longer follow-up time. Subsequent pregnancies were not associated with an increase in the rate of aortic dilation in patients with MS.