PMID- 34185797
OWN - NLM
STAT- MEDLINE
DCOM- 20211117
LR  - 20211117
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 16
IP  - 6
DP  - 2021
TI  - Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review 
      and meta-analysis.
PG  - e0253581
LID - 10.1371/journal.pone.0253581 [doi]
LID - e0253581
AB  - PURPOSE: Associations between rheumatic heart disease (RHD) in pregnancy and 
      fetal outcomes are relatively unknown. This study aimed to review rates and 
      predictors of major adverse fetal outcomes of RHD in pregnancy. METHODS: Medline 
      (Ovid), Pubmed, EMcare, Scopus, CINAHL, Informit, and WHOICTRP databases were 
      searched for studies that reported rates of adverse perinatal events in women 
      with RHD during pregnancy. Outcomes included preterm birth, intra-uterine growth 
      restriction (IUGR), low-birth weight (LBW), perinatal death and percutaneous 
      balloon mitral valvuloplasty intervention. Meta-analysis of fetal events by the 
      New-York Heart Association (NYHA) heart failure classification, and the 
      Mitral-valve Area (MVA) severity score was performed with unadjusted random 
      effects models and heterogeneity of risk ratios (RR) was assessed with the I2 
      statistic. Quality of evidence was evaluated using the GRADE approach. The study 
      was registered in PROSPERO (CRD42020161529). FINDINGS: The search identified 5949 
      non-duplicate records of which 136 full-text articles were assessed for 
      eligibility and 22 studies included, 11 studies were eligible for meta-analyses. 
      In 3928 pregnancies, high rates of preterm birth (9.35%-42.97%), LBW 
      (12.98%-39.70%), IUGR (6.76%-22.40%) and perinatal death (0.00%-9.41%) were 
      reported. NYHA III/IV pre-pregnancy was associated with higher rates of preterm 
      birth (5 studies, RR 2.86, 95%CI 1.54-5.33), and perinatal death (6 studies, RR 
      3.23, 1.92-5.44). Moderate /severe mitral stenosis (MS) was associated with 
      higher rates of preterm birth (3 studies, RR 2.05, 95%CI 1.02-4.11) and IUGR (3 
      studies, RR 2.46, 95%CI 1.02-5.95). INTERPRETATION: RHD during pregnancy is 
      associated with adverse fetal outcomes. Maternal NYHA III/IV and moderate/severe 
      MS in particular may predict poor prognosis.
FAU - Liaw, Joshua
AU  - Liaw J
AUID- ORCID: 0000-0002-7900-3938
AD  - College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 
      Australia.
FAU - Walker, Betrice
AU  - Walker B
AD  - College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 
      Australia.
FAU - Hall, Leanne
AU  - Hall L
AD  - College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 
      Australia.
FAU - Gorton, Susan
AU  - Gorton S
AD  - College of Medicine and Dentistry, James Cook University, Townsville, Queensland, 
      Australia.
FAU - White, Andrew V
AU  - White AV
AD  - College of Medicine and Dentistry, James Cook University, Townsville, Queensland, 
      Australia.
FAU - Heal, Clare
AU  - Heal C
AD  - College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 
      Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20210629
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Female
MH  - Humans
MH  - Infant
MH  - *Infant Mortality
MH  - Infant, Newborn
MH  - Mitral Valve Stenosis/*mortality
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*mortality
MH  - Premature Birth/*mortality
MH  - Rheumatic Heart Disease/*mortality
PMC - PMC8241043
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/06/30 06:00
MHDA- 2021/11/18 06:00
PMCR- 2021/06/29
CRDT- 2021/06/29 17:18
PHST- 2021/03/23 00:00 [received]
PHST- 2021/06/08 00:00 [accepted]
PHST- 2021/06/29 17:18 [entrez]
PHST- 2021/06/30 06:00 [pubmed]
PHST- 2021/11/18 06:00 [medline]
PHST- 2021/06/29 00:00 [pmc-release]
AID - PONE-D-21-09543 [pii]
AID - 10.1371/journal.pone.0253581 [doi]
PST - epublish
SO  - PLoS One. 2021 Jun 29;16(6):e0253581. doi: 10.1371/journal.pone.0253581. 
      eCollection 2021.