Pregnancy loss in major fetal congenital heart disease: incidence, risk factors and timing

Fetuses with congenital heart disease (CHD) are at increased risk of pregnancy loss compared to the general population. This study aimed to identify pregnancy loss incidence, timing and risk factors in major fetal CHD overall and by cardiac diagnosis. Of 9351 UBDN cases with a cardiovascular code, we identified 3251 with major CHD, resulting in a study cohort of 3120 after excluding terminations (n=131). The study findings suggested that pregnancy loss risk is higher in major fetal CHD compared to the general population, driven by CHD type and additional fetal diagnoses. Recognition of pregnancy loss incidence, risk factors and timing may inform patient counselling, antenatal surveillance, and delivery planning.