Key result
Heart disease affects ~1.5% of pregnant women in South Asia, predominantly driven by rheumatic heart disease.
Why the study?
The prevalence and paradigm of antenatal heart disease differ between high-income and low- and middle-income countries, prompting a review of its prevalence and spectrum in pregnant women of South Asia.
Meta-Analysis
Heart disease affects 1.46% of pregnant women in South Asia, predominantly driven by rheumatic heart disease, and is associated with significant maternal and fetal mortality.
Answers are grounded in this paper and cite their sources.
High prevalence and mortality warrant clinical attention in South Asian pregnancies; extends meta-analytic estimates of rheumatic heart disease burden.
Background: The prevalence and paradigm of antenatal heart disease are contrasting between high-income, industrialized, and low- and middle-income countries. In this systematic review, we report the prevalence of heart disease and its spectrum in pregnant women of South Asia. Methods: We searched through different electronic databases (PubMed, Google-scholar, Embase, Cochrane Library) to locate relevant articles. Studies with sufficient data that met our inclusion criteria were included. Two reviewers independently screened the articles. Discrepancies were resolved by other reviewers. Subsequently, data extraction was done using a standardized form and quality assessment of studies using the Joanna Briggs Institute tool. Meta-analysis was done using R software. Results: After various stages of screening 25 studies were included in the final quantitative synthesis. The pooled prevalence of heart disease among pregnant women was 1.46% (95% CI 0.99-2.01). Among those with heart disease, 70.25% (95% CI 64.87-75.38) had Rheumatic heart disease and 18.10% (95% CI 14.39-22.12) had congenital heart disease. The pooled prevalence of preterm labor and delivery among pregnant women with heart disease was 17.63% (95% CI 12.18-23.80). Similarly, the pooled maternal and fetal mortality rates were 26.14 (95% CI 12.47-43.55) and 50.48 (95% CI 29.59-75.83) per 1000 pregnant women with heart disease respectively. Conclusion: As pregnancy, itself is a prolonged state of physiologic stress, heart disease further adds to the risk both for the mother and fetus. Having such a high prevalence, efforts must be made to detect and closely monitor the condition antenatally, and decisions should be made according to the clinical conditions of the patient.
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Shrestha et al. (2022) conducted a meta-analysis in Heart disease in pregnancy. Heart disease during pregnancy was evaluated on Pooled prevalence of heart disease among pregnant women (95% CI 0.99-2.01). The pooled prevalence of heart disease among pregnant women in South Asia was 1.46%, with rheumatic heart disease accounting for 70.25% of cases and maternal mortality reaching 26.14 per 1000 pregnancies.
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