Severe rheumatic cardiac disease and pregnancy: the ultimate prognosis

All of 134 women classified as having "functionally severe" rheumatic cardiac disease and surviving pregnancies in 1931 through 1943 have been traced to 1975. Ninety-three percent have died at the exponential rate of 6.3% per year. The women with and without pregnancies following admittance to the series were similar in respect to age at entry, ages in which they lived, and proportionate representation in all but one of five subgroups with extraordinarily high death rates in the first five years of follow-up. Analyses of the data by life tables, average annual death rates, lengths of survival, and average ages at death failed to uncover any evidence for a delayed adverse effect of pregnancy in the whole series or in any of the subgroups. Provided that the patient survives the gestation, the life expectancy is not shortened by pregnancy.