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Pregnancy and postpartum infective endocarditis: a systematic review
Kalie Y Kebed1, Kalkidan Bishu2, Raed I Al Adham3
1Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Mayo Clinic Proceedings
|July 6, 2014
Summary
Infective endocarditis (IE) during pregnancy is a rare but serious condition. Key risk factors include intravenous drug use and heart conditions, with streptococcal species being common pathogens.
Area of Science:
- Cardiology
- Infectious Diseases
- Obstetrics
Background:
- Infective endocarditis (IE) poses significant risks during pregnancy and the postpartum period.
- Understanding evolving risk factors and outcomes is crucial for maternal and fetal health.
Purpose of the Study:
- To systematically review the clinical characteristics, risk factors, and outcomes of infective endocarditis in pregnant and postpartum women.
- To identify trends in pathogens and associated conditions.
Main Methods:
- Systematic review of literature from 1988 to 2012 using Ovid MEDLINE, Embase, Web of Science, and Scopus.
- Inclusion of studies reporting on women meeting modified Duke criteria for IE during pregnancy or postpartum.
- Analysis of 90 cases from 72 studies.
Main Results:
- Peripartum IE predominantly affected native valves (92%).
- Primary risk factors included intravenous drug use (14%), congenital heart disease (12%), and rheumatic heart disease (12%).
- Streptococcal (43%) and staphylococcal (26%) species were the most frequent pathogens. Maternal mortality was 11%, with 14% fetal mortality.
Conclusions:
- Infective endocarditis is a life-threatening condition in pregnancy with changing risk factor profiles.
- Intravenous drug use is an increasing risk factor, while rheumatic heart disease has decreased.
- Early recognition and management are vital for improving maternal and fetal outcomes in peripartum IE.
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