The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high-income setting: a prospective cohort study.

Autor:	Sullivan, EA, Vaughan, G, Li, Z, Peek, MJ, Carapetis, JR, Walsh, W, Frawley, J, Rémond, MGW, Remenyi, B, Jackson Pulver, L, Kruske, S, Belton, S, McLintock, C, Sullivan, E A, Peek, M J, Carapetis, J R
Předmět:	RHEUMATIC heart disease PREGNANCY CORONARY care units PREGNANT women INDIGENOUS Australians CARDIOVASCULAR diseases in pregnancy INCOME LONGITUDINAL method RESEARCH funding BODY mass index DISEASE prevalence PARITY (Obstetrics)
Zdroj:	BJOG: An International Journal of Obstetrics & Gynaecology; Jan2020, Vol. 127 Issue 1, p47-56, 10p, 4 Charts
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu Plný text