Open Access

REVIEW

Safety of contraceptive use among women with congenital heart disease: A systematic review

by

1 Department of Pediatrics, Division of Pediatric Cardiology, Washington University School of Medicine/St. Louis Children’s Hospital, St. Louis, Missouri
2 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
3 Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia

* Corresponding Author: Ginnie Abarbanell, Department of Pediatrics, Division of Pediatric Cardiology, Washington University School of Medicine/St. Louis Children’s Hospital, 660 South Euclid, Campus Box 8116, St. Louis, MO 63110. Email:

Congenital Heart Disease 2019, 14(3), 331-340. https://doi.org/10.1111/chd.12752

Abstract

Objective: Women with congenital heart disease (CHD) are at increased risk of preg‐ nancy complications and need information on safe, effective contraceptive methods to avoid unintended pregnancy. This systematic review examines evidence regarding safety of contraceptive use among women with CHD.
Methods: The PubMed database was searched for any peer‐reviewed articles pub‐ lished through April 2018 that included safety outcomes associated with reversible contraceptive methods among women with CHD.
Results: Five articles met inclusion criteria: three studies comparing contraceptive users to nonusers and two noncomparative studies. Sample sizes ranged from 65 to 505 women with CHD. Two studies found a higher percent of thromboembolic com‐ plications among women with Fontan palliation or transposition of the great arteries using oral contraceptives. One study, among women with Fontan palliation, found no increased risk of thromboembolic complications between contraceptive users (not separated by type) and nonusers. Two studies found no endocarditis among intrau‐ terine device users.
Conclusions: There is a paucity of data regarding the safety of contraceptive meth‐ ods among women with CHD. Limited evidence suggests an increased incidence of thromboembolic complications with use of oral contraceptives. Further studies are needed to evaluate contraceptive safety and quantify risk in this growing population. There is also limited data regarding the safety of contraceptive methods among women with CHD. Further information is needed to assist practitioners counseling women with CHD on safety of contraceptive methods.

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