The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study
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...
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| Published in: | BJOG : an international journal of obstetrics and gynaecology Vol. 127; no. 1; pp. 47 - 56 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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England
Wiley Subscription Services, Inc
01.01.2020
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| ISSN: | 1470-0328, 1471-0528, 1471-0528 |
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| Abstract | 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
Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.
Tweetable
Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. |
|---|---|
| AbstractList | 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
Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.
Tweetable
Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).OBJECTIVETo describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).Prospective population-based study.DESIGNProspective population-based study.Hospital-based maternity units throughout A&NZ.SETTINGHospital-based maternity units throughout A&NZ.Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014.POPULATIONPregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014.We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed.METHODSWe identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed.Prevalence of RHD in pregnancy. Perinatal morbidity and mortality.MAIN OUTCOME MEASURESPrevalence of RHD in pregnancy. Perinatal morbidity and mortality.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.RESULTSThere 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.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.CONCLUSIONRheumatic 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.Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.TWEETABLE ABSTRACTRheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). Prospective population-based study. Hospital-based maternity units throughout A&NZ. Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014. We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed. Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. 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. 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. Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. ObjectiveTo describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).DesignProspective population‐based study.SettingHospital‐based maternity units throughout A&NZ.PopulationPregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014.MethodsWe identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De‐identified antenatal, perinatal and postnatal data were collected and analysed.Main outcome measuresPrevalence of RHD in pregnancy. Perinatal morbidity and mortality.ResultsThere 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.ConclusionRheumatic 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 abstractRheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. |
| Author | Frawley, J Jackson Pulver, L Belton, S Peek, MJ Carapetis, JR Sullivan, EA McLintock, C Remenyi, B Li, Z Rémond, MGW Kruske, S Vaughan, G Walsh, W |
| Author_xml | – sequence: 1 givenname: EA orcidid: 0000-0002-8718-2753 surname: Sullivan fullname: Sullivan, EA email: E.Sullivan@newcastle.edu.au organization: University of Technology Sydney – sequence: 2 givenname: G orcidid: 0000-0002-0132-9946 surname: Vaughan fullname: Vaughan, G organization: University of Technology Sydney – sequence: 3 givenname: Z orcidid: 0000-0002-7622-150X surname: Li fullname: Li, Z organization: University of Technology Sydney – sequence: 4 givenname: MJ surname: Peek fullname: Peek, MJ organization: The Australian National University – sequence: 5 givenname: JR surname: Carapetis fullname: Carapetis, JR organization: Perth Children's Hospital – sequence: 6 givenname: W surname: Walsh fullname: Walsh, W organization: Prince of Wales Hospital – sequence: 7 givenname: J surname: Frawley fullname: Frawley, J organization: University of Technology Sydney – sequence: 8 givenname: MGW orcidid: 0000-0001-7796-4447 surname: Rémond fullname: Rémond, MGW organization: University of Technology Sydney – sequence: 9 givenname: B surname: Remenyi fullname: Remenyi, B organization: Charles Darwin University – sequence: 10 givenname: L surname: Jackson Pulver fullname: Jackson Pulver, L organization: The University of Sydney – sequence: 11 givenname: S surname: Kruske fullname: Kruske, S organization: Institute for Urban Indigenous Health Ltd – sequence: 12 givenname: S surname: Belton fullname: Belton, S organization: Charles Darwin University – sequence: 13 givenname: C surname: McLintock fullname: McLintock, C organization: Auckland City Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31512355$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1111_ajo_13102 crossref_primary_10_1186_s12884_021_04305_3 crossref_primary_10_1111_ajo_13559 crossref_primary_10_1136_heartjnl_2020_316648 crossref_primary_10_1002_ijgo_13907 crossref_primary_10_1016_j_hlc_2024_04_301 crossref_primary_10_1111_aogs_14104 crossref_primary_10_3389_fpubh_2022_933654 crossref_primary_10_1136_bmjopen_2023_083467 crossref_primary_10_1016_j_hlc_2020_06_021 crossref_primary_10_4081_jphr_2021_2137 crossref_primary_10_1161_JAHA_120_016851 crossref_primary_10_1016_j_hlc_2020_10_002 crossref_primary_10_1016_j_hlc_2021_10_017 crossref_primary_10_1371_journal_pone_0253581 crossref_primary_10_5694_mja2_50853 crossref_primary_10_1016_j_jacadv_2024_101368 crossref_primary_10_1016_j_hlc_2022_07_013 |
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| Copyright | 2019 Royal College of Obstetricians and Gynaecologists 2019 Royal College of Obstetricians and Gynaecologists. Copyright © 2020 Royal College of Obstetricians and Gynaecologists |
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| Keywords | stillbirth First Nations maternal health perinatal outcomes rheumatic heart disease |
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| Snippet | Objective
To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).
Design
Prospective population‐based... Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity. To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). Prospective population-based study.... ObjectiveTo describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).DesignProspective population‐based... To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).OBJECTIVETo describe the epidemiology of... |
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| SubjectTerms | Adult Birth Births Body Mass Index Cardiovascular disease Cohort analysis Coronary artery disease Epidemiology Female First Nations Gestation Health risk assessment Heart Heart diseases Humans Income Intensive care Intensive care units maternal health Morbidity Neonates New Zealand - epidemiology New Zealand - ethnology Northern Territory - epidemiology Northern Territory - ethnology Parity perinatal outcomes Population studies Postpartum Pregnancy Pregnancy Complications, Cardiovascular - ethnology Prevalence Prospective Studies Rheumatic heart disease Rheumatic Heart Disease - ethnology stillbirth Womens health Young Adult |
| Title | The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study |
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