Current problems in cardiology · 2025
Impact of cardio-obstetrics care on maternal outcomes in pregnant women with heart disease: A systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sebastian Sneha Annie, Atwal Harshan, Ayyalu Tanesh, Gulati Martha
Аннотация
BACKGROUND: Maternal mortality is at an all-time high in the U.S., with maternal cardiac disease being the leading cause of death. Cardio-obstetrics is a collaborative, multidisciplinary approach to maternal care, bringing together experts from maternal-fetal medicine, cardiology, and other specialties. This study investigates the impact of cardio-obstetrics team care on maternal outcomes, focusing on how this integrated model can improve the health and well-being of pregnant women with cardiovascular disease (CVD).
METHODS: We conducted a systematic review by searching MEDLINE, Web of Science, Scopus, and Cochrane up to March 5, 2025. Statistical analysis was performed using RevMan 5.4, with an inverse variance random effects model to calculate risk ratios (RR) for dichotomous outcomes. Heterogeneity was assessed using the Higgins I² test. The study protocol is registered in PROSPERO (CRD420251010149).
RESULTS: We identified six observational studies evaluating cardio-obstetrics team care, including a total of 1,109 pregnant women with CVD, with a mean age of 30.8 years. Most participants had a CARPREG II score > 2, indicating high risk for adverse maternal cardiovascular outcomes. The average gestational age at delivery was 38 weeks, with arrhythmias being the most common cardiovascular condition, followed by congenital and valvular heart disease. Pooled analysis revealed a statistically significant reduction in the 30-day postpartum readmission rate for pregnant women with CVD receiving cardio-obstetrics care compared to standard care (RR 0.29, 95 % CI: 0.13-0.64, p = 0.002, I² = 0 %) with no observed heterogeneity. There was also a significant decrease in postpartum arrhythmias (RR 0.07, 95 % CI: 0.04-0.12, p < 0.001, I² = 0 %). However, no significant difference in maternal mortality was found between the two groups (RR 0.74, 95 % CI: 0.14-3.93, p = 0.72, I² = 0 %).
CONCLUSION: Maternal outcomes with cardio-obstetrics team care in pregnant women with CVD were promising, indicating the potential of this integrated care model when compared with standard care. These results emphasize the need for further research to explore its long-term benefits. Standard care data were approximated using national averages due to the lack of direct comparison data, which should be considered when interpreting the results.
LAY SUMMARY: Heart disease is the leading cause of death during pregnancy in the U.S. This study looked at whether having a specialized cardio-obstetrics team made up of doctors from different specialties working together improves outcomes for pregnant women with heart disease. Six studies with >1,100 women found that women cared for by these cardio-obstetrics teams had fewer hospital readmissions and fewer heart rhythm problems after delivery, though death rates were not different.
METHODS: We conducted a systematic review by searching MEDLINE, Web of Science, Scopus, and Cochrane up to March 5, 2025. Statistical analysis was performed using RevMan 5.4, with an inverse variance random effects model to calculate risk ratios (RR) for dichotomous outcomes. Heterogeneity was assessed using the Higgins I² test. The study protocol is registered in PROSPERO (CRD420251010149).
RESULTS: We identified six observational studies evaluating cardio-obstetrics team care, including a total of 1,109 pregnant women with CVD, with a mean age of 30.8 years. Most participants had a CARPREG II score > 2, indicating high risk for adverse maternal cardiovascular outcomes. The average gestational age at delivery was 38 weeks, with arrhythmias being the most common cardiovascular condition, followed by congenital and valvular heart disease. Pooled analysis revealed a statistically significant reduction in the 30-day postpartum readmission rate for pregnant women with CVD receiving cardio-obstetrics care compared to standard care (RR 0.29, 95 % CI: 0.13-0.64, p = 0.002, I² = 0 %) with no observed heterogeneity. There was also a significant decrease in postpartum arrhythmias (RR 0.07, 95 % CI: 0.04-0.12, p < 0.001, I² = 0 %). However, no significant difference in maternal mortality was found between the two groups (RR 0.74, 95 % CI: 0.14-3.93, p = 0.72, I² = 0 %).
CONCLUSION: Maternal outcomes with cardio-obstetrics team care in pregnant women with CVD were promising, indicating the potential of this integrated care model when compared with standard care. These results emphasize the need for further research to explore its long-term benefits. Standard care data were approximated using national averages due to the lack of direct comparison data, which should be considered when interpreting the results.
LAY SUMMARY: Heart disease is the leading cause of death during pregnancy in the U.S. This study looked at whether having a specialized cardio-obstetrics team made up of doctors from different specialties working together improves outcomes for pregnant women with heart disease. Six studies with >1,100 women found that women cared for by these cardio-obstetrics teams had fewer hospital readmissions and fewer heart rhythm problems after delivery, though death rates were not different.