The contribution of heart disease to pregnancy-related mortality according to the pregnancy mortality surveillance system

Burlingame, Janet; Horiuchi, Brian Y.; Ohana, Patrick; Onaka, Alvin T.; Sauvage, Lynnae

doi:10.1038/jp.2011.74

Cited by 31 publications

(13 citation statements)

References 30 publications

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“…The most prominent causes of maternal death were peripartum cardiomyopathy, myocardial infarction, and arrhythmias. 5 Similar fi ndings were reported in a 2002-2006 review in California. 6 Ethnic and racial disparities in maternal outcomes exist in the United States: eg, in black women, the risk of pregnancy-related death is 3 times higher than in women of oth-er races.…”

Section: ■ Maternal Mortality Rates Risingsupporting

confidence: 77%

Cardio-obstetrics: Recognizing and managing cardiovascular complications of pregnancy

Shapero

Desai²,

Elder

et al. 2020

CCJM

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Pregnancy can exacerbate known cardiovascular disorders and unmask previously unrecognized problems. Patients with congenital heart disorders, valvular disease, primary pulmonary hypertension, hypertensive disorders of pregnancy, and acquired peripartum cardiomyopathy need a collaborative interdisciplinary team that includes a cardiologist with specialty training in obstetrics. KEY POINTS Several trends are increasing cardiovascular risk in pregnancy. The average maternal age at fi rst pregnancy is increasing, survival in congenital heart disease has improved, and cardiovascular risk factors are developing at younger ages. Maternal morbidity and mortality are increasing, with cardiovascular diseases accounting for over one-quarter of peripartum and postpartum deaths. Rates of maternal mortality from cardiovascular disease are highest among low-income women and women of color. The emergence of new cardiovascular complications during pregnancy is often considered a failed stress test and can increase the risk of future cardiovascular disease. Women should be monitored closely after pregnancy in order to improve maternal outcomes and prevent the development of future cardiovascular disease.

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Section: ■ Maternal Mortality Rates Risingsupporting

confidence: 77%

Cardio-obstetrics: Recognizing and managing cardiovascular complications of pregnancy

Shapero

Desai²,

Elder

et al. 2020

CCJM

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“…In other words, they lacked any data on deaths associated with pregnancy losses. The distribution by country of these studies was as follows: one in Bangladesh, 28 one in Brazil, 29 two in Canada, 30 , 31 one in Denmark, 32 one in Italy, 33 three in Netherlands, 34 – 36 four in Sweden, 37 – 39 one in Taiwan, 40 six in the United Kingdom, 41 – 46 thirty-four in the United States including Puerto Rico, 47 – 79 and three reporting data from multiple countries for which at least one country’s data used record linkage which met our criteria for inclusion. 80 – 82 …”

Section: Resultsmentioning

confidence: 99%

Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: A systematic review with a narrative synthesis and meta-analysis

Reardon¹,

Thorp

2017

SAGE Open Medicine

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Objectives:Measures of pregnancy associated deaths provide important guidance for public health initiatives. Record linkage studies have significantly improved identification of deaths associated with childbirth but relatively few have also examined deaths associated with pregnancy loss even though higher rates of maternal death have been associated with the latter. Following PRISMA guidelines we undertook a systematic review of record linkage studies examining the relative mortality risks associated with pregnancy loss to develop a narrative synthesis, a meta-analysis, and to identify research opportunities.Methods:MEDLINE and SCOPUS were searched in July 2015 using combinations of: mortality, maternal death, record linkage, linked records, pregnancy associated mortality, and pregnancy associated death to identify papers using linkage of death certificates to independent records identifying pregnancy outcomes. Additional studies were identified by examining all citations for relevant studies.Results:Of 989 studies, 11 studies from three countries reported mortality rates associated with termination of pregnancy, miscarriage or failed pregnancy. Within a year of their pregnancy outcomes, women experiencing a pregnancy loss are over twice as likely to die compared to women giving birth. The heightened risk is apparent within 180 days and remains elevated for many years. There is a dose effect, with exposure to each pregnancy loss associated with increasing risk of death. Higher rates of death from suicide, accidents, homicide and some natural causes, such as circulatory diseases, may be from elevated stress and risk taking behaviors.Conclusions:Both miscarriage and termination of pregnancy are markers for reduced life expectancy. This association should inform research and new public health initiatives including screening and interventions for patients exhibiting known risk factors.

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“…Pregnancy causes tremendous neurological and endocrine changes, including an activated renin-angiotensin-aldosterone system [ 15 ] and an increased level of cortisol and the catecholamine adrenaline [ 16 , 17 ]. Heart disease and heart failure following pregnancy-induced hypertension [ 18 , 19 ] and gestational diabetes [ 20 ] are not uncommon in pregnant women. It is reasonable to presume that severe burns might aggravate the pathological changes of gravida and result in a deteriorative outcome based on the current knowledge on pathological changes for pregnancy and severe burns.…”

Section: Discussionmentioning

confidence: 99%

Severe burn injury in late pregnancy: a case report and literature review

et al. 2015

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The management of serious burn injuries during pregnancy is an unsolved clinical problem because of the low incidence of this disease. Although it has been documented that the effect of burns on fetal and maternal survival is detrimental, there have been conflicting reports among the different burn centers regarding the mortality of burned pregnant women and the management of burn patients during pregnancy. We report a case of severe burn in late pregnancy treated at our burn center. Additionally, we searched and summarized the literature concerning the management of pregnant patients to provide useful information for their treatment.

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The contribution of heart disease to pregnancy-related mortality according to the pregnancy mortality surveillance system

Abstract: Heart disease is the most common cause of pregnancy-related mortality in Hawaii, and with improved ascertainment, may be determined to be the most common cause of pregnancy-related mortality in the rest of the United States.

Cited by 31 publications

References 30 publications

Cardio-obstetrics: Recognizing and managing cardiovascular complications of pregnancy

Cardio-obstetrics: Recognizing and managing cardiovascular complications of pregnancy

Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: A systematic review with a narrative synthesis and meta-analysis

Severe burn injury in late pregnancy: a case report and literature review

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