Risk for CHF During Pregnancy in Cancer Survivors

Pregnant woman speaking to doctor
Pregnant woman speaking to doctor
Investigators sought to determine the incidence of cardiac decompensation during pregnancy in cancer survivors.

The risk of developing congestive heart failure (CHF) during pregnancy is uncommon in women who were cancer survivors who do not have a history of cardiotoxicity, according to research published in Journal of the American College of Cardiology.

Researchers retrospectively studied 78 women who were cancer survivors and their 94 pregnancies. The women had undergone cardiotoxic chemotherapies and/or radiation as children, during adolescence, or as young adults and received care at high-risk pregnancy clinics between 2005 and 2015. Fifty-five women received anthracyclines, and 23 received nonanthracycline chemotherapy and/or radiation therapy.

The frequency of CHF was 31% (4 of 13) (95% CI, 13%-58%) and 0% (0 of 65) (95% CI, 0%-6%) in women who had a history of cardiotoxicity and those who did not, respectively (P <.001). In women with (n=4) and without CHF (n=74) while pregnant, there were no variations when looking at age at cancer diagnosis, age at pregnancy, type of cancer, or prior exposure to anthracyclines. Women who experienced CHF during pregnancy were more likely to have a history of cardiotoxicity prior to pregnancy (100% vs 12%; P =.007), have LV systolic dysfunction at initial antenatal appointment (75% vs 8%; P =.004), or be on cardiac treatment regimens (50% vs 8%; P =.026) compared with those who did not have CHF.

Researchers conclude that “the risk of developing CHF during pregnancy is rare in [women who were] cancer survivors without a history of cardiotoxicity.” In women with a history of cardiotoxicity, there is approximately a 1 in 3 chance of developing CHF during pregnancy, and these women require close monitoring.

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Liu S, Aghel N, Belford L, et al. Cardiac Outcomes in Pregnant Women With Treated CancerJ Am Coll Cardiol. 2018;72(17):2087-2089.