Syncope in pregnancy, immediate pregnancy outcomes, and offspring long-term neurologic health

Trends and Immediate Outcomes of Syncope During Pregnancy: A Narrative Review

“…In particular, regardless of when the syncope occurs during pregnancy, there is a 52% increased risk of intrauterine growth restriction (IUGR), especially with syncope in the first trimester, a 33% higher chance of cesarean delivery, and a 79% increased risk of long-term neurological morbidity in offspring. These findings demonstrate the substantial effect that maternal syncope has on the mother's and the child's short- and long-term health outcomes [ 13 ].…”

“…Similarly, a retrospective cohort study was conducted including all singleton deliveries occurring between the years 1991 and 2021 at a large tertiary medical center. The study population included 232,475 pregnancies, 774 (0.3%) of which were affected by maternal syncope, which most frequently first occurred during the second trimester (44.5%), followed by the first trimester (31.8%) and finally the third trimester (27.7%) [ 13 ]. There is an increase in the incidence of syncope in pregnancy and this warrants further exploration of the phenomenon.…”

“…There is limited information on the patterns of syncope during pregnancy, although certain studies have indicated that there is a higher chance of syncope during the first trimester. This increased risk is probably caused by vasovagal processes, hormonal variations, and hemodynamic alterations [ 13 , 14 ]. Furthermore, data indicates that women who already have cardiovascular disease or a history of syncope may be more susceptible to syncopal episodes during pregnancy [ 10 , 13 ].…”

“…This increased risk is probably caused by vasovagal processes, hormonal variations, and hemodynamic alterations [ 13 , 14 ]. Furthermore, data indicates that women who already have cardiovascular disease or a history of syncope may be more susceptible to syncopal episodes during pregnancy [ 10 , 13 ]. The physiological changes during pregnancy, including increased blood volume, decreased vascular resistance, and hormonal fluctuations, can lead to altered autonomic regulation, making pregnant women more susceptible to syncope [ 15 , 16 ].…”

“…Pregnant women may experience arrhythmias, such as supraventricular tachycardia, which can cause syncope [8,13]. Structural heart diseases or congenital heart conditions that were previously asymptomatic can become symptomatic during pregnancy due to the increased cardiac workload, potentially leading to episodes of syncope [23][24][25].…”