Friday, June 7, 2019

Fainting During Pregnancy Can Be a Sign of Problems for Both Mother and Baby

Women have long been told fainting is a common but harmless symptom of pregnancy, but new research published in the Journal of the American Heart Association found that it may indicate issues for both the baby and mother’s health, especially when it occurs during the first trimester.

For the study, Safia Chatur, MD, University of Calgary, Calgary, Alberta, and colleagues reviewed birth records of 481,930 babies born between 2005 and 2014, as well as medical records of the mothers for 1 year after delivery, looking for frequency, timing, and outcomes of fainting episodes.

The researchers found that roughly 1% of expectant mothers fainted. Overall, 32.3% of the syncope episodes first occurred in the first trimester, 44.1% in the second trimester, and 23.6% in the third trimester; and 8% of pregnancies had >1 episode of syncope.

Compared with women without syncope, women who experienced syncope were younger and primiparous.

The rate of preterm birth was higher in pregnancies with syncope during the first trimester (18.3%) compared with the second (15.8%) and third trimesters (14.2%) and pregnancies without syncope (15%; P< .01).

The incidence of congenital anomalies among children born of pregnancies with multiple syncope episodes was significantly higher (4.9%) compared with children of pregnancies without syncope (2.9%; P< .01).

Within 1 year after delivery, women with syncope during pregnancy had higher rates of cardiac arrhythmias and syncope episodes than women with no syncope during pregnancy.

Women who faint during pregnancy should report it to their physicians, who should monitor the women and their babies more closely, said Padma Kaul, PhD, University of Calgary.

“Pregnancy is a natural stress test for the woman’s system,” she said. “Fainting during pregnancy may identify women who are at higher risk of cardiovascular complications down the road.”

Until now, research about fainting during pregnancy relied on anecdotal reporting and a small number of case studies. The pattern of issues for mothers and babies was only revealed when researchers were able to review a large number of birth records from a 10-year time period.

While a large proportion of the population faints at some point in their lifetime, the underlying causes can be difficult to diagnose and can range from life-threatening to benign.

While the study shows a correlation between fainting and health issues for mothers and babies, it cannot pinpoint causes or pre-existing conditions that might be responsible, said Dr. Kaul.

“It is a chicken-and-egg problem, so the associations need to be worked out through further study,” she concluded.

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