TY - JOUR
T1 - Cardiovascular Deaths in Pregnancy
T2 - Growing Concerns and Preventive Strategies
AU - Keepanasseril, Anish
AU - Pfaller, Birgit
AU - Metcalfe, Amy
AU - Siu, Samuel C
AU - Davis, Melinda B
AU - Silversides, Candice K
N1 - Funding Information:
Support was provided by a grant from the Allan E. Tiffin Trust (Toronto General and Western Hospital Foundation). Dr Silversides is supported by the Miles Nadal Chair in Pregnancy and Heart Disease (Mount Sinai Hospital Foundation).
Publisher Copyright:
© 2021 Canadian Cardiovascular Society
PY - 2021/12
Y1 - 2021/12
N2 - There has been an increase in maternal deaths from cardiovascular disease in many countries. In high-income countries, cardiovascular deaths secondary to cardiomyopathies, ischemic heart disease, sudden arrhythmic deaths, aortic dissection, and valve disease are responsible for up to one-third of all pregnancy-related maternal deaths. In low- and middle-income countries, rheumatic heart disease is a much more common cause of cardiac death during pregnancy. Although deaths occur in women with known heart conditions or cardiovascular risk factors such as hypertension, many women present for the first time in pregnancy with unrecognised heart disease or with de novo cardiovascular conditions such as preeclampsia, peripartum cardiomyopathy, spontaneous coronary artery dissection. Not only has maternal cardiovascular mortality increased, but serious cardiac morbidity, or "near misses," during pregnancy also have increased in frequency. Although maternal morbidity and mortality are often preventable, many health professionals remain unaware of the impact of cardiovascular disease in this population, and the lack of awareness contributes to inappropriate care and preventable deaths. In this review, we discuss the maternal mortality from cardiovascular causes in both high- and low- and middle-income countries and strategies to improve outcomes.
AB - There has been an increase in maternal deaths from cardiovascular disease in many countries. In high-income countries, cardiovascular deaths secondary to cardiomyopathies, ischemic heart disease, sudden arrhythmic deaths, aortic dissection, and valve disease are responsible for up to one-third of all pregnancy-related maternal deaths. In low- and middle-income countries, rheumatic heart disease is a much more common cause of cardiac death during pregnancy. Although deaths occur in women with known heart conditions or cardiovascular risk factors such as hypertension, many women present for the first time in pregnancy with unrecognised heart disease or with de novo cardiovascular conditions such as preeclampsia, peripartum cardiomyopathy, spontaneous coronary artery dissection. Not only has maternal cardiovascular mortality increased, but serious cardiac morbidity, or "near misses," during pregnancy also have increased in frequency. Although maternal morbidity and mortality are often preventable, many health professionals remain unaware of the impact of cardiovascular disease in this population, and the lack of awareness contributes to inappropriate care and preventable deaths. In this review, we discuss the maternal mortality from cardiovascular causes in both high- and low- and middle-income countries and strategies to improve outcomes.
KW - Cause of Death/trends
KW - Female
KW - Global Health
KW - Guidelines as Topic
KW - Humans
KW - Maternal Death/etiology
KW - Maternal Mortality/trends
KW - Morbidity/trends
KW - Pregnancy
KW - Pregnancy Complications, Cardiovascular/epidemiology
KW - Prevalence
KW - Preventive Medicine/standards
KW - Risk Factors
UR - http://www.scopus.com/inward/record.url?scp=85120887730&partnerID=8YFLogxK
U2 - 10.1016/j.cjca.2021.09.022
DO - 10.1016/j.cjca.2021.09.022
M3 - Review article
C2 - 34600086
SN - 0828-282X
VL - 37
SP - 1969
EP - 1978
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 12
ER -