{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:37:56Z","timestamp":1791005876249,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Prolonged QT intervals have been observed in pregnant women, which predispose them to a higher risk of potentially lethal ventricular arrhythmias. This study was designed to evaluate the prevalence of QTc prolongation in Chinese hospitalized parturient women with single and twin pregnancies, and to explore potential risk factors associated with QTc prolongation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 1,218 patients from a large Chinese population between January 2014 and October 2020. Data from parturient women with single and twin pregnancies without pre-pregnancy cardiac diseases were collected. QTc was corrected by the Fridericia formula [QTc = QT\/RR(1\/3)], and QTc \u2265 460 ms for females was defined as prolonged QTc, QTc \u2265 500 ms was defined as severely prolonged QTc. The prevalence and common risk factors of QTc prolongation during pregnancy were analyzed in this cohort. Uni- and multivariable logistic regression analysis were performed to identify clinical parameters associated with QTc prolongation in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of QTc prolongation was 48.19% among this population, 10.56% in single pregnancy, 89.44% in twin pregnancies. The prevalence of severely prolonged QTc was 23.48% among the total cohort, 0.49% in single pregnancy, and 46.47% in twin pregnancies. The mean QTc interval was significantly longer in twin pregnancies than in single pregnancy (498.65 \u00b1 38.24 vs. 424.96 \u00b1 27.67 ms, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). Systolic blood pressure, diastolic blood pressure, total cholesterol, serum uric acid, gestational hypertension and twin pregnancies were associated with QTc prolongation in parturient women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study to assess the prevalence and risk factors of QTc prolongation between single and twin pregnancies. QTc prolongation is more prevalent, and QTc intervals are significantly longer in twin pregnancies as compared to single pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2021.819901","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T05:11:40Z","timestamp":1643001100000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence and Risk Factors of QTc Prolongation During Pregnancy"],"prefix":"10.3389","volume":"8","author":[{"given":"Chaodi","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenzhen","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1002\/cphy.c140043","article-title":"Cardiac physiology of pregnancy","volume":"5","author":"May","year":"2015","journal-title":"Compr Physiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s11936-018-0660-9","article-title":"Cardiac arrhythmias and pregnancy","volume":"20","author":"MacIntyre","year":"2018","journal-title":"Curr Treat Options Cardiovasc Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1053\/j.semperi.2014.04.017","article-title":"Cardiac arrhythmias in pregnancy","volume":"38","author":"Knotts","year":"2014","journal-title":"Semin Perinatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1089\/jwh.2013.4617","article-title":"Maternal mortality and morbidity in the United States: where are we now?","volume":"23","author":"Creanga","year":"2014","journal-title":"J Womens Health."},{"key":"B5","unstructured":"Pregnancy Mortality Surveillance System"},{"key":"B6","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1053\/j.semperi.2017.07.007","article-title":"Epidemiology of maternal morbidity and mortality","volume":"41","author":"Hirshberg","year":"2017","journal-title":"Semin Perinatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1001\/archinternmed.2011.433","article-title":"QT-interval duration and mortality rate: results from the Third National Health and Nutrition Examination Survey","volume":"171","author":"Zhang","year":"2011","journal-title":"Arch Intern Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1111\/anec.12285","article-title":"Electrocardiographic P-wave duration, QT interval, T peak to end interval and Tp-e\/QT ratio in pregnancy with respect to trimesters","volume":"21","author":"Tanindi","year":"2016","journal-title":"Ann Noninvasive Electrocardiol."},{"key":"B9","first-page":"22","article-title":"QT interval in pregnant and non-pregnant women","volume":"2","author":"Zamani","year":"2014","journal-title":"Emergency."},{"key":"B10","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/0735-1097(95)00122-G","article-title":"Dispersion of QT interval in patients with and without susceptibility to ventricular tachyarrhythmias after previous myocardial infarction","volume":"26","author":"Perkiomaki","year":"1995","journal-title":"J Am Coll Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e273","DOI":"10.1161\/CIR.0000000000000527","article-title":"Update to practice standards for electrocardiographic monitoring in hospital settings: A Scientific Statement From the American Heart Association","volume":"136","author":"Sandau","year":"2017","journal-title":"Circulation."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1016\/S0140-6736(99)02107-8","article-title":"Long QT syndromes and torsade de pointes","volume":"354","author":"Viskin","year":"1999","journal-title":"Lancet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.psym.2012.11.001","article-title":"QTc prolongation, torsades de pointes, and psychotropic medications","volume":"54","author":"Beach","year":"2013","journal-title":"Psychosomatics."},{"key":"B14","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.vascn.2013.01.003","article-title":"A new biomarker\u2013index of cardiac electrophysiological balance (iCEB)\u2013plays an important role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs)","volume":"68","author":"Lu","year":"2013","journal-title":"J Pharmacol Toxicol Methods."},{"key":"B15","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.tcm.2006.07.001","article-title":"Heart hypertrophy during pregnancy: a better functioning heart?","volume":"16","author":"Eghbali","year":"2006","journal-title":"Trends Cardiovasc Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.yjmcc.2016.06.001","article-title":"Physiological and pathological cardiac hypertrophy","volume":"97","author":"Shimizu","year":"2016","journal-title":"J Mol Cell Cardiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1080\/00015385.2018.1440905","article-title":"QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy","volume":"74","author":"Patel","year":"2019","journal-title":"Acta Cardiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1253\/circj.CJ-14-1290","article-title":"QTc interval prolongation predicts arrhythmia recurrence after catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy","volume":"79","author":"Wen","year":"2015","journal-title":"Circ J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.jacc.2006.08.057","article-title":"Long QT syndrome in adults","volume":"49","author":"Sauer","year":"2007","journal-title":"J Am Coll Cardiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/978-1-4939-3121-7","article-title":"How to determine cardiac ion channels targeted by drugs using the isolated rabbit ventricular wedge model","volume":"81","author":"Liu","year":"2016","journal-title":"J Pharmacol Toxicol Methods."},{"key":"B21","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1177\/1535370218777972","article-title":"Dysfunctional Nav1.5 channels due to SCN5A mutations","volume":"243","author":"Han","year":"2018","journal-title":"Exp Biol Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/978-3-642-41588-3_7","article-title":"The role of late I Na in development of cardiac arrhythmias","volume":"221","author":"Antzelevitch","year":"2014","journal-title":"Handb Exp Pharmacol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e1013","DOI":"10.4088\/JCP.16m11318","article-title":"Corrected QT interval and methadone dose and concentrations in pregnant and postpartum women","volume":"78","author":"Bogen","year":"2017","journal-title":"J Clin Psychiatry."},{"key":"B24","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.jacc.2018.10.075","article-title":"Use of medication for cardiovascular disease during pregnancy: JACC state-of-the-art review","volume":"73","author":"Halpern","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1185\/03007995.2013.840568","article-title":"QT interval prolongation and the risk of torsades de pointes: essentials for clinicians","volume":"29","author":"Trinkley","year":"2013","journal-title":"Curr Med Res Opin."},{"key":"B26","doi-asserted-by":"publisher","first-page":"682054","DOI":"10.1155\/2015\/682054","article-title":"Mechanisms linking red blood cell disorders and cardiovascular diseases","volume":"2015","author":"Mozos","year":"2015","journal-title":"Biomed Res Int."},{"key":"B27","doi-asserted-by":"publisher","first-page":"22186","DOI":"10.1074\/jbc.M110.198853","article-title":"Progesterone impairs human ether-a-go-go-related gene (HERG) trafficking by disruption of intracellular cholesterol homeostasis","volume":"286","author":"Wu","year":"2011","journal-title":"J Biol Chem."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-019-01137-2","article-title":"Association between serum uric acid levels and coronary artery disease in different age and gender: a cross-sectional study","author":"Sun","year":"2019","journal-title":"Aging Clin Exp Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1016\/j.amjcard.2018.11.027","article-title":"Implications of hyperuricemia in severe coronary artery disease","volume":"123","author":"Zhang","year":"2019","journal-title":"Am J Cardiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1038\/hr.2015.30","article-title":"Modulation of the QT interval duration in hypertension with antihypertensive treatment","volume":"38","author":"Klimas","year":"2015","journal-title":"Hypertens Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3109\/01443615.2015.1036401","article-title":"Does pregnancy-induced hypertension affect the electrophysiology of the heart?","volume":"36","author":"Gazi","year":"2016","journal-title":"J Obstet Gynaecol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.pcad.2018.04.004","article-title":"Obesity and ventricular repolarization: a comprehensive review","volume":"61","author":"Omran","year":"2018","journal-title":"Prog Cardiovasc Dis."},{"key":"B33","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1016\/j.bpobgyn.2013.08.001","article-title":"Alterations in physiology and anatomy during pregnancy","volume":"27","author":"Tan","year":"2013","journal-title":"Best Pract Res Clin Obstetr Gynaecol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"273","DOI":"10.4037\/aacnacc2018911","article-title":"Physiologic and hemodynamic changes during pregnancy","volume":"29","author":"Troiano","year":"2018","journal-title":"Adv Crit Care."},{"key":"B35","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1038\/jp.2016.261","article-title":"Blood pressure during pregnancy, neonatal size and altered body composition: the Healthy Start study","volume":"37","author":"Starling","year":"2017","journal-title":"J Perinatol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s00399-021-00757-4","article-title":"Arrhythmic risk during pregnancy and postpartum in patients with long QT syndrome","volume":"32","author":"Asatryan","year":"2021","journal-title":"Herzschrittmacherther Elektrophysiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1089\/jwh.2011.3444","article-title":"Sex hormones and the QT interval: a review","volume":"21","author":"Sedlak","year":"2012","journal-title":"J Womens Health."},{"key":"B38","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/0002-9378(78)90476-3","article-title":"Human placental lactogen, estradiol-17beta, and progesterone levels in the third trimester and their respective values for detecting twin pregnancies","volume":"131","author":"Batra","year":"1978","journal-title":"Am J Obstet Gynecol."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.819901\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T05:11:45Z","timestamp":1643001105000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.819901\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":38,"alternative-id":["10.3389\/fcvm.2021.819901"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.819901","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,24]]},"article-number":"819901"}}