The Late Effects of Pregnancy on Aortic Dimensions in Patients with Marfan Syndrome

While the immediate effects of pregnancy on aortic dimension in patients with Marfan syndrome (MFS) have been evaluated, the late effects of subsequent pregnancies in these patients are less known. For this purpose, we evaluated 2 groups of women with MFS who were under specialized care in our institution. Group A included 23 women with MFS who experienced 55 pregnancies; group B included 12 nulliparous MFS patients. Patients in group A were similar in age (36.13 +/- 5.6 years vs. 34.25 +/- 6.54 years, p = 0.41) and follow-up time (group A 6.05 +/- 3.56 years and group B 4.92 +/- 3.37 years, p = 0.37). Baseline aortic root diameters as well as the aortic root diameters at follow-up visits were similar between groups (35.60 +/- 4.42 vs. 35.08 +/- 3.82 mm, p = 0.73, and 37.57 +/- 4.66 vs. 37.33 +/- 4.83 mm, p = 0.89, respectively). The aortic root diameter increased by 0.5 (0, 2) mm in group A and 1 (0, 4.5) mm in group B (p = 0.54). The rate of aortic dilation per year of follow-up was similar between the groups (0.34 +/- 0.52 mm/year in group A vs. 0.55 +/- 0.75 mm/year in group B [p = 0.52]). Chronic medical treatment was similar in both groups. Patients in both groups were treated similarly with beta-blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. In summary, subsequent pregnancies in patients with MFS were not associated with an increase in the rate of aortic root dilation in these patients.