Outcome of Pregnancy in Women With Congenitally Corrected Transposition of the Great Arteries: A Systematic Review

Jena Pizula; Nare Torosyan; Sarah Solimon; Jenica Thangathurai; Anil Mehra; Amy Chatfield; Uri Elkayam

doi:10.1016/j.amjcard.2025.03.021

Outcome of Pregnancy in Women With Congenitally Corrected Transposition of the Great Arteries: A Systematic Review

Am J Cardiol. 2025 Apr 22:250:9-16. doi: 10.1016/j.amjcard.2025.03.021. Online ahead of print.

Authors

Jena Pizula¹, Nare Torosyan², Sarah Solimon³, Jenica Thangathurai², Anil Mehra², Amy Chatfield⁴, Uri Elkayam⁵

Affiliations

¹ Department of Cardiovascular Medicine, Stanford University, Stanford, California 94305. Electronic address: jpizula@stanford.edu.
² Department of Cardiovascular Medicine, University of Southern California, Los Angeles, California 90033.
³ Department of Internal Medicine, University of Southern California, Los Angeles, California 90033.
⁴ Department of Library Sciences, University of Southern California, Los Angeles, California 90033.
⁵ Department of Cardiovascular Medicine, Stanford University, Stanford, California 94305; Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California 90033.

PMID: 40274205
DOI: 10.1016/j.amjcard.2025.03.021

Abstract

Congenitally corrected transposition of the great arteries (ccTGA or L-TGA) presents potentially challenging cardiac physiology in the pregnant state. While women with ccTGA often live into childbearing age, little is known about the maternal and fetal outcomes of pregnancy in this rare and heterogenous patient population. We performed a systematic review of the literature over the last 25 years to further investigate these outcomes. A total of 107 women who had 178 pregnancies were analyzed. Maternal outcomes demonstrated: mortality (0.6%), hospitalization (24.5%), heart failure (9.6%) and arrythmia (11.2%). Fetal outcomes included live birth (83.6 %), premature deliveries (10.2%), cesarian section (44.6%), and congenital heart disease identified in offspring (1.9%). Overall mortality was low but high rates of hospitalization highlight the importance of monitoring for potential morbidity and complication in this patient population. While this is the largest review to date on maternal and fetal outcomes in pregnancy in women with ccTGA, future studies are warranted to augment our understanding of cardiovascular and obstetrical outcomes in this population.