Key result
The prevalence of rheumatic heart disease in pregnancy in Australia and New Zealand was 4.3 per 10,000 women giving birth (95% CI 3.9-4.8), with significant associated cardiac and perinatal morbidity.
Why the study?
The epidemiology and impact of rheumatic heart disease in pregnancy in Australia and New Zealand remained to be described.
Cohort (n=311)
Yes
Rheumatic heart disease in pregnancy remains highly prevalent among First Nations populations in Australia and New Zealand and is associated with substantial maternal and perinatal morbidity.
Answers are grounded in this paper and cite their sources.
Supports targeted surveillance in First Nations populations; leaves open optimal prevention strategies.
OBJECTIVE: To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). DESIGN: Prospective population-based study. SETTING: Hospital-based maternity units throughout A&NZ. POPULATION: Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014. METHODS: We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed. MAIN OUTCOME MEASURES: Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. RESULTS: There were 311 pregnancies associated with women with RHD (4.3/10 000 women giving birth, 95% CI 3.9-4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10 000, 95% CI 50.7-70.0), while in New Zealand 90% were Māori or Pasifika (27.2/10 000, 95% CI 22.0-32.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1000 births) and two neonatal deaths (6.5/1000 births). Sixty-six (21%) live-born babies were preterm and one in three was admitted to neonatal intensive care or special care units. CONCLUSION: Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at-risk pregnant women are essential for good maternal and baby outcomes. TWEETABLE ABSTRACT: Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.
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Sullivan et al. (2019) conducted a cohort in Rheumatic heart disease in pregnancy (n=311). Rheumatic heart disease was evaluated on Prevalence of RHD in pregnancy (95% CI 3.9-4.8). The prevalence of rheumatic heart disease in pregnancy in Australia and New Zealand was 4.3 per 10,000 women giving birth (95% CI 3.9-4.8), with significant associated cardiac and perinatal morbidity.
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