PMID- 34840063
OWN - NLM
STAT- MEDLINE
DCOM- 20220322
LR  - 20220322
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 31
IP  - 4
DP  - 2022 Apr
TI  - The Spectrum, Severity and Outcomes of Rheumatic Mitral Valve Disease in Pregnant 
      Women in Australia and New Zealand.
PG  - 480-490
LID - S1443-9506(21)01314-7 [pii]
LID - 10.1016/j.hlc.2021.10.017 [doi]
AB  - BACKGROUND: Rheumatic heart disease (RHD) poses significant perinatal risks. We 
      aimed to describe the spectrum, severity and outcomes of rheumatic mitral valve 
      disease in pregnancy in Australia and New Zealand. METHODS: A prospective, 
      population-based cohort study of pregnant women with RHD recruited 2013-14 
      through the hospital-based Australasian Maternity Outcomes Surveillance System. 
      Outcome measures included maternal and perinatal morbidity and mortality. 
      Univariable and multivariable logistic regression analyses were undertaken to 
      test for predictors of adverse maternal and perinatal outcomes. RESULTS: Of 274 
      pregnant women identified with RHD, 124 (45.3%) had mitral stenosis (MS) and 150 
      (54.7%) had isolated mitral regurgitation (MR). One woman with mild MS/moderate 
      MR died. There were six (2.2%) stillbirths and two (0.7%) neonatal deaths. Babies 
      born to women with MS were twice as likely to be small-for-gestational-age (22.7% 
      vs 11.4%, p=0.013). In women with MS, use of cardiac medication (AOR 7.42) and 
      having severe stenosis (AOR 16.35) were independently associated with adverse 
      cardiac outcomes, while New York Heart Association (NYHA) class >1 (AOR 3.94) was 
      an independent predictor of adverse perinatal events. In women with isolated MR, 
      use of cardiac medications (AOR 7.03) and use of anticoagulants (AOR 6.05) were 
      independently associated with adverse cardiac outcomes. CONCLUSIONS: Careful 
      monitoring and specialist care for women with RHD in pregnancy is required, 
      particularly for women with severe MS, those on cardiac medication, and those on 
      anticoagulation, as these are associated with increased risk of adverse maternal 
      cardiac outcomes. In the context of pregnancy, contraception and preconception 
      planning are important for young women diagnosed with RHD.
CI  - Copyright (c) 2021 Australian and New Zealand Society of Cardiac and Thoracic 
      Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). 
      Published by Elsevier B.V. All rights reserved.
FAU - Remond, Marc G W
AU  - Remond MGW
AD  - Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, 
      Australia.
FAU - Li, Zhuoyang
AU  - Li Z
AD  - Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, 
      Australia.
FAU - Vaughan, Geraldine
AU  - Vaughan G
AD  - College of Science and Sustainability, CQUniversity Australia, Sydney, NSW, 
      Australia.
FAU - Frawley, Jane
AU  - Frawley J
AD  - Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
FAU - Peek, Michael J
AU  - Peek MJ
AD  - ANU Medical School, College of Health and Medicine, The Australian National 
      University, Canberra, ACT, Australia.
FAU - Carapetis, Jonathan R
AU  - Carapetis JR
AD  - Telethon Kids Institute, The University of Western Australia, Perth, WA, 
      Australia.
FAU - Remenyi, Bo
AU  - Remenyi B
AD  - Menzies School of Health Research, Charles Darwin University, Darwin, NT, 
      Australia.
FAU - Parsonage, William
AU  - Parsonage W
AD  - Australian Centre for Health Service Innovation, Queensland University of 
      Technology, Brisbane, Qld, Australia.
FAU - McLintock, Claire
AU  - McLintock C
AD  - National Women's Health, Auckland City Hospital, Auckland, New Zealand.
FAU - Sullivan, Elizabeth A
AU  - Sullivan EA
AD  - Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, 
      Australia. Electronic address: e.sullivan@newcastle.edu.au.
LA  - eng
PT  - Journal Article
DEP - 20211126
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Mitral Valve
MH  - *Mitral Valve Stenosis/diagnosis/epidemiology
MH  - New Zealand/epidemiology
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular/epidemiology
MH  - Pregnant Women
MH  - Prospective Studies
MH  - *Rheumatic Heart Disease/complications/diagnosis/epidemiology
OTO - NOTNLM
OT  - Maternal health
OT  - Perinatal outcomes
OT  - Pregnancy
OT  - Rheumatic heart disease
EDAT- 2021/11/30 06:00
MHDA- 2022/03/23 06:00
CRDT- 2021/11/29 05:45
PHST- 2020/12/21 00:00 [received]
PHST- 2021/08/16 00:00 [revised]
PHST- 2021/10/21 00:00 [accepted]
PHST- 2021/11/30 06:00 [pubmed]
PHST- 2022/03/23 06:00 [medline]
PHST- 2021/11/29 05:45 [entrez]
AID - S1443-9506(21)01314-7 [pii]
AID - 10.1016/j.hlc.2021.10.017 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2022 Apr;31(4):480-490. doi: 10.1016/j.hlc.2021.10.017. Epub 
      2021 Nov 26.