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Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting

Andrea Beaton1,2, Emmy Okello3, Amy Scheel4

  • 1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Heart (British Cardiac Society)
|November 12, 2018
PubMed

Insights

Undiagnosed heart disease, primarily rheumatic heart disease, significantly contributes to adverse pregnancy outcomes and mortality in low-income countries. Early detection through screening is crucial for improving maternal and infant health.

Area of Science:

  • Cardiology
  • Maternal Health
  • Global Health

Background:

  • Cardiovascular disease burden and its impact on pregnancy outcomes are poorly quantified, especially in low-income settings.
  • Pre-existing heart conditions pose significant risks during pregnancy.
  • Active case-finding for maternal heart disease is needed.

Purpose of the Study:

  • To determine the prevalence of maternal heart disease using active case finding.
  • To quantify the attributable risk of maternal heart disease to adverse pregnancy outcomes.
  • To highlight the impact of undiagnosed heart disease in pregnant women in Uganda.

Main Methods:

  • A 24-month prospective longitudinal study in three Ugandan health centers.
  • Active case finding of heart disease using echocardiography during antenatal care.
  • Follow-up of women to 6 weeks postpartum to assess pregnancy outcomes and mortality.

Main Results:

  • Prevalence of heart disease was 17 per 1000 women; 15 per 1000 had rheumatic heart disease.
  • Only 3.4% of women had a prior diagnosis of heart disease.
  • Heart disease was associated with 88.6% of maternal mortality in the exposed group and 10.8% overall.

Conclusions:

  • Undiagnosed maternal heart disease contributes substantially to adverse pregnancy outcomes in low-resource settings.
  • Rheumatic heart disease is the most common condition, necessitating global prioritization.
  • Active screening for heart disease during antenatal care is vital for improving maternal and fetal health.
Abstract

Keywords:
global healthpregnancyvalvular heart disease

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