日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 38(2): 105-114 (2022)
doi:10.9794/jspccs.38.105

原著Original

成人先天性心疾患女性のリプロダクティブ・ヘルス向上にむけた妊娠出産に関する予備的調査Preliminary Study on Pregnancy and Childbirth to Improve the Reproductive Health of Women with Congenital Heart Disease

山﨑 啓子1，井上 彩香2，澤渡 浩之3，吉本 祐子4，坂本 一郎5，山村 健一郎6，新原 亮史7，谷口 初美2，樗木 晶子1,8Keiko Yamasaki1, Ayaka Inoue2, Hiroyuki Sawatari3, Yuko Yoshimoto4, Ichiro Sakamoto5, Kenichiro Yamamura6, Ryoji Shinbara7, Hatsumi Taniguchi2, Akiko Chishaki1,8

1 福岡看護大学Fukuoka Nursing College ◇ Fukuoka, Japan

2 福岡女学院看護大学Fukuoka Jo Gakuin Nursing University ◇ Fukuoka, Japan

3 広島大学大学院医系科学研究科 周手術期・クリティカルケア開発学Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University ◇ Hiroshima, Japan

4 東京大学病院看護部Department of Nursing, The University of Tokyo Hospital ◇ Tokyo, Japan

5 九州大学大学院医学研究院循環器内科学Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences ◇ Fukuoka, Japan

6 九州大学大学院医学研究院小児科学Department of Pediatrics, Kyushu University Graduate School of Medical Sciences ◇ Fukuoka, Japan

7 九州大学病院看護部Department of Nursing, Kyushu University Hospital ◇ Fukuoka, Japan

8 福岡歯科大学医科歯科総合病院健診センターHealth Care Center, Fukuoka Dental College Hospital ◇ Fukuoka, Japan

受付日：2021年4月11日Received: April 11, 2021
受理日：2022年2月28日Accepted: February 28, 2022
発行日：2022年5月1日Published: May 1, 2022
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背景・目的：近年，先天性心疾患（CHD）患者の多くが成人を迎えることが可能となり，増加する成人CHD（ACHD）女性の結婚，妊娠・出産に関する認識を検討した．

方法： ACHD女性307名（20～49歳）へ心疾患と結婚・妊娠・出産に関する質問紙調査を行い，対象者を身体障害者手帳1級取得者と非取得者に分けて比較した．

結果：回答した取得者53名，非取得者36名の89名（有効回答率29.0％）を対象とした．既婚者は取得者に多く，結婚の希望は非取得者に多い傾向があり，両群共に80％が「妊娠・出産による心臓の負担」「妊娠前検査の必要性」を認識していた．取得者は，「治療薬の胎児への影響」「心疾患の胎児への遺伝」の認識が高かった．

結論：ACHD女性は，妊娠・出産による心臓への負担を認識していても，その願望は高く，看護職者や医師が連携して心疾患重症度に応じて妊娠可能性やリスクについて早期からの啓発や継続支援が必要である．

Background: The number of adult patients with congenital heart disease (CHD) who get married, become pregnant, and give birth is increasing with the improvement in their prognosis. We examined the hope and cognition of the marriages, pregnancies, and childbirth of women with CHD.

Methods: A questionnaire-based survey was conducted on 307 adult women with CHD (aged 20–49 years) regarding their heart diseases, marriages, pregnancies, and childbirth. We divided the subjects into two groups according to whether they had or had not acquired the first grade of the physical disability certificate.

Results: Responses were obtained from 89 participants (valid response rate: 29.0％), including 53 acquirers and 36 nonacquirers. The number of married people was significantly more frequent in the acquirer than in the nonacquirer group. In both groups, 80％ were aware of the “Burden on the heart due to pregnancy” and “Necessity of prepregnancy examinations.” The acquirers were highly aware of “Influences of heart disease medications on the fetus” and “Inheritance of congenital heart disease by the fetus.”

Conclusions: Both groups reported high aspirations for marriage, pregnancy, and childbirth. They need to be supported and educated continuously for a safe pregnancy and childbirth by a multidisciplinary team.

Key words: adult congenital heart disease; reproductive health; pregnancy and childbirth

© 2022 特定非営利活動法人日本小児循環器学会© 2022 Japanese Society of Pediatric Cardiology and Cardiac Surgery

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