Maternal and neonatal outcomes in pregnant women undergoing cardiac surgery: a systematic review and meta-analysis

Objective Cardiac diseases that require surgical intervention present a unique challenge during pregnancy and may affect both maternal and neonatal outcomes. This systematic review and meta-analysis aimed to evaluate maternal and neonatal outcomes in pregnant females undergoing cardiac surgery.Methods A comprehensive manual and electronic search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Sciences databases for studies published up to 31st May 2024. Eligible studies were required to report maternal and neonatal outcomes of women who underwent cardiac surgery during pregnancy. Random-effects meta-analysis was conducted to estimate pooled maternal and neonatal mortality proportions, and the results were presented as risk ratios (RR) with 95% confidence intervals (CIs).Results Seventeen studies met the inclusion criteria, comprising a total sample size of 196 pregnant women who underwent cardiac surgery. Cardiac surgery during pregnancy was significantly (p < 0.001) linked to increased maternal and neonatal mortality, with pooled RR of 4.9% (CI: 2.1%−7.6%) and 26.5% (CI: 19.7%−33.4%), respectively.Conclusion This study highlights the significant risks associated with cardiac surgery during pregnancy, such as increased risk of maternal and neonatal mortality and higher incidence of preterm labor. Our findings underscore the importance of specialized care and multidisciplinary management for pregnant women with cardiac conditions. Further research is warranted to identify strategies for risk mitigation and improved outcomes in this vulnerable population.