Increased Risk of Preterm Birth among Women with Mitral Valve Prolapse: A Nationwide, Population-Based Study

Purpose: Using nationwide population-based databases, we aimed to assess the association between mitral valve prolapse (MVP) and adverse pregnancy outcomes. Methods: The Taiwan Birth Registry and the National Health Insurance Research Dataset were used for analysis. Of all pregnant women in Taiwan who had singleton births in 2005, we identified a total of 3104 mothers diagnosed with MVP during ambulatory or emergency care visits, together with 12,245 mothers unaffected by MPV. Multivariate logistic regression was performed. Results: Multivariate logistic regressions showed that, compared with unaffected mothers, the adjusted odds ratios of preterm birth and cesarean section for mothers with MVP were 1.27 (95% confidence interval [CI], 1.10-1.48) and 1.34 (95% CI, 1.20-1.50), respectively. In further stratification based on the timing of the MVP diagnosis, the highest risks of preterm birth were observed for mothers diagnosed with MVP during (but not before) pregnancy (odds ratio [OR], 1.54; p = .001). No significant difference was observed between women with and without MVP for other outcomes such as low birthweight, intrapartum complications, low Apgar scores, and congenital malformations. Conclusions: Our study found a significant risk of preterm delivery among women with MVP. A multidisciplinary team approach to providing obstetric care, with the mission of monitoring signs of cardiac complications and preterm birth, is imperative.