Maternal cardiac and perinatal outcomes among pregnant individuals with tetralogy of Fallot

Background Tetralogy of Fallot (TOF) is associated with maternal-fetal risks during pregnancy, particularly in those with uncorrected or residual defects. Methods This retrospective cohort study identified pregnancies with TOF and compared them with pregnancies with other congenital heart diseases (CHDs) using ICD-10 codes, between 5/23/22 and 5/22/25. Demographic and clinical characteristics were analyzed using analysis of variance or Student’s t -tests for continuous variables and chi-square tests for categorical variables. Results There were 1574 women (1961 pregnancies) with TOF compared to 37,899 women (47,239 pregnancies) with other CHD. Significant differences in cardiac outcomes were observed in arrhythmias (32.9% vs. 18.3%), particularly ventricular arrhythmias (6.8% vs. 2.1%) and endocarditis (2.4% vs. 1.5%). Significant perinatal outcomes included preterm delivery (17% vs. 14.1%) and earlier gestational age at delivery (37.4 ± 3 vs. 38.9 ± 1.7). Conclusions Pregnancies with TOF have a greater occurrence of adverse cardiac outcomes, particularly arrhythmias and endocarditis, and obstetric outcomes, including preterm delivery.