- 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
- Creator
- Sullivan, E. A.; Vaughan, G.; Kruske, S.; Belton, S.; McLintock, C.; Li, Z.; Peek, M. J.; Carapetis, J. R.; Walsh, W.; Frawley, J.; Rémond, M. G. W.; Remenyi, B.; Jackson Pulver, L.
- Relation
- BJOG: An International Journal of Obstetrics & Gynaecology Vol. 127, Issue 1, p. 47-56
- Publisher Link
- http://dx.doi.org/10.1111/1471-0528.15938
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2020
- Description
- 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 Maori 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.
- Subject
- First Nations; maternal health; perinatal outcomes; rheumatic heart disease; stillbirth; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1451381
- Identifier
- uon:44174
- Identifier
- ISSN:1470-0328
- Language
- eng
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