The frequency of syncope and other cardiovascular events in the mother in the year following the delivery was also evaluated. Additionally, neonatal outcomes, including rates of preterm birth, small for gestational age (SGA), large for gestational age, and congenital anomalies were examined, overall, and according to the timing (first occurrence in first, second, or third trimester), and number (≥1) of syncope episodes during pregnancy. Given this paucity of evidence, we sought to describe temporal trends in the incidence of syncope during pregnancy using a large, contemporary, population‐based cohort of women in a defined geographic area with a single‐payer healthcare system with universal access. While most case reports suggest a benign course for both mother and child, there are no long‐term follow‐up data. 7 Moreover, the effect of a transient fall in blood pressure on maternal and fetal outcomes is not well described. There are currently limited data on the incidence of syncope in pregnancy. These changes may predispose her to the development of syncope. 4 The pregnant mother undergoes a number of hemodynamic changes 5 including reduced systemic vascular resistance, increased blood volume and heart rate, and eccentric hypertrophy of the left ventricle. 3 Moreover, it has been shown that there is a significant association between syncope and the presence of cardiovascular disease, and the relationship appears to be stronger among young people. This is reflected in the prognosis of 1‐year mortality estimates ranging from as low as 0% for vasovagal syncope up to 30% in the context of cardiac syncope. Syncope may be a manifestation of a number of clinical conditions occurring on a spectrum of severity from deadly underlying heart conditions such as arrhythmia to benign conditions such as vasovagal episodes. 2 The most common cause of syncope in adolescents and young adults, including women of childbearing age, is vasovagal syncope. 1 It is a relatively common clinical problem, presenting in a bimodal distribution, with the highest incidence occurring between ages 10 to 30 and in patients older than 65 years. Syncope is the sudden, transient loss of consciousness that occurs as a result of global cerebral hypoperfusion. Given the observed higher rates of adverse outcomes among women experiencing syncope in pregnancy, closer monitoring both during pregnancy and in the postpartum period may be necessitated. 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. 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<0.01). 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 (15.0% P<0.01). Compared with women without syncope, women who experienced syncope were younger (age <25 years 34.7% versus 20.8% P<0.001), and primiparous (52.1% versus 42.4% P<0.001). Overall, 1506 (32.3%) of the syncope episodes first occurred in the first trimester, 2058 (44.1%) in the second trimester, and 1103 (23.6%) in the third trimester and 8% (n=377) of pregnancies had >1 episode of syncope. Poisson regression analysis found a 5% increase/year (rate ratio, 1.05 95% CI, 1.04–1.06) in the age‐adjusted incidence of syncope. Of 481 930 pregnancies, 4667 had an episode of syncope. This was a retrospective study of pregnancies between January 1, 2005, and December 31, 2014, in the province of Alberta, Canada.
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