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Poster Session 1

Category: Medical/Surgical/Diseases/Complications

Poster Session 1

(259) Preterm Birth in a Heterogeneous Cohort of Patients with Acquired and Inherited Heart Disease

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Presenting Author(s)

KB

Kelecia Brown, MD

Physician
Wake Forest School of Medicine, Charlotte Campus
Charlotte, North Carolina, United States

Coauthor(s)

LC

Leah Carnick Ledford, MSN, RN

Nurse Practitioner
Wake Forest School of Medicine, Charlotte Campus
Charlotte, North Carolina, United States

Submitting Author(s)

Sequoia Finney, BS (she/her/hers)

Project Manager
Wake Forest School of Medicine, Charlotte Campus
Charlotte, North Carolina, United States

Coauthor(s)

TG

Tasha L. Gill, MPH, PhD

Research Assistant Professor
Wake Forest School of Medicine, Charlotte Campus
Charlotte, North Carolina, United States
JM

Julio Mateus Nino, MD, PhD

Physician
Wake Forest School of Medicine, Charlotte Campus
Charlotte, North Carolina, United States

Objective:
Women with heart disease are at risk for adverse pregnancy outcomes, including preterm birth (PTB). This study aimed to determine whether the New York Heart Association (NYHA) Functional Classification of heart failure can help to estimate the risk for PTB and to identify the most common indications for PTB in this high-risk population.

Study Design:
This was a retrospective cohort study of patients with inherited and acquired heart disease and singleton pregnancies who received care in a cardio-obstetrics clinic from August 1, 2018, to November 15, 2023. Patients were evaluated by a cardiologist, Maternal-Fetal Medicine specialist, and nurse practitioner. NYHA classification (I, II, III, IV, or unknown) was assigned at the first visit. PTB was defined as delivery < 37 0/7 weeks. Indication for PTB were analyzed. Multivariate logistic regression was used to assess the association between NYHA classification and PTB.

Results:
Among 119 singleton pregnancies, 25 (21%) had PTB. There were no significant differences in heart disease diagnosis, age, race, BMI, history of PTB and parity between the PTB and term birth groups. The most common indications for PTB included maternal cardiac complications 9 (36%), PPROM 7 (28%), and preeclampsia 4 (16%). Among PTB cases, 11 (31%) had Class I, 9 (25%) had Class II, and 5 (14%) had Class III/IV. Compared with Class I, the odds for PTB were 3.8 times higher with Class II (OR=3.84, 95% CI:1.37-10.78) and 11 times higher with Class III/IV: OR=11.36, 95%CI: 2.38-54.35). After adjusting for pre-pregnancy BMI and history of PTB, the odds of PTB for Class II increased, while the odds of Class III/IV attenuated (Class II: OR=4.77, 95%CI: 1.56-14.60; Class III/IV: OR= 7.56, 95%CI: 1.25-45.73).

Conclusion:
The NYHA classification appears to be a useful clinical tool to estimate the risk for PTB. The increasing rates of PTB by NYHA class underscores the importance of preventive measures such as optimization of NYHA during pregnancy and low-dose aspirin.