ZAHARA Risk Score: Explanation and Clinical Context
The ZAHARA (Zwangerschap bij Aangeboren HARtAfwijking) risk score is a tool developed to assess the risk of adverse cardiac events during pregnancy in women with congenital heart disease. It incorporates eight clinical variables: history of arrhythmias, use of cardiac medications before pregnancy, New York Heart Association (NYHA) functional class greater than II, left heart obstruction, systemic atrioventricular (AV) valve regurgitation, pulmonary AV valve regurgitation, mechanical valve prosthesis, and cyanotic heart disease. Each variable is assigned a score of 1.5 points. The total score is calculated by summing the points for each positive variable. A higher ZAHARA score indicates an increased risk of cardiac complications during pregnancy. This tool aids clinicians in stratifying risk and planning appropriate management strategies for pregnant women with congenital heart disease.
Reference:
Silversides CK, Grewal J, Mason J, et al. Pregnancy Outcomes in Women With Heart Disease: The CARPREG II Study. J Am Coll Cardiol 2018;71:2419-2430. doi:10.1016/j.jacc.2018.02.076