Abstract
Cardiovascular disease complicates pregnancy and elevates maternal and fetal risks. Local data in Saudi Arabia is scarce. This study examines pregnancy outcomes in women with cardiovascular disease at a tertiary center. A retrospective cohort study of 103 cardio-obstetric patients (2015-2023) at King Khalid University Hospital. Multivariable logistic regression identified risk factors for adverse maternal and neonatal outcomes, with significance at p < 0.05. The cohort (mean age = 35.5 ± 5.03 years, mean BMI = 31.33 ± 6.32 kg/m(2)) had high rates of hypertension (45.6 %) and preterm delivery (<37 weeks: 37/101, 36.6 %). Maternal hypertension occurred in 14.7 % (15/102). Neonatal outcomes included NICU admission (15.7 %, 16/102) and fetal loss (6.8 %, 7/103). Multivariable analysis revealed that a history of preeclampsia increased the odds of preterm birth (OR = 7.29, 95 % CI [2.16-24.63], p = 0.001), maternal hypertension (OR = 8.38, 95 % CI [1.90-36.97], p < 0.01), and NICU admission (OR = 6.98, 95 % CI [1.78-27.40], p < 0.01). Pre-existing diabetes (Types I/II) was associated with preterm birth (OR = 7.74, 95 % CI [1.70-35.24], p < 0.01). A higher BMI independently increased the odds of maternal hypertension (OR = 1.14 per unit, 95 % CI [1.01-1.28], p < 0.05). Bivariate analysis indicated that autoimmune disease increased the risk of low APGAR scores (0-6: 57.1 % vs. 11.1 %, p = 0.008), and prior cardiac procedures increased the risk of fetal loss (18.8 % vs. 4.6 %, p = 0.039). A history of preeclampsia, diabetes, and elevated BMI is a critical risk factor. Multidisciplinary preconception counseling and stringent antenatal monitoring are essential for this high-risk.