The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high-income setting: a prospective cohort study.

Sullivan, EA; Vaughan, G; Li, Z; Peek, MJ; Carapetis, JR; Walsh, W; Frawley, J; Rémond, M; Remenyi, B; Jackson Pulver, L; Kruske, S; Belton, S; McLintock, C

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high-income setting: a prospective cohort study.

Sullivan, EA Vaughan, G

Li, Z

Peek, MJ Carapetis, JR Walsh, W Frawley, J

Rémond, M Remenyi, B Jackson Pulver, L Kruske, S

Belton, S McLintock, C

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: BJOG: an International Journal of Obstetrics and Gynaecology, 2020, 127, (1), pp. 47-56
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Sullivan, EA
dc.contributor.author	Vaughan, G https://orcid.org/0000-0002-0132-9946
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X
dc.contributor.author	Peek, MJ
dc.contributor.author	Carapetis, JR
dc.contributor.author	Walsh, W
dc.contributor.author	Frawley, J https://orcid.org/0000-0001-6037-0140
dc.contributor.author	Rémond, M
dc.contributor.author	Remenyi, B
dc.contributor.author	Jackson Pulver, L
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954
dc.contributor.author	Belton, S
dc.contributor.author	McLintock, C
dc.date.accessioned	2020-09-29T06:23:00Z
dc.date.available	2019-09-02
dc.date.available	2020-09-29T06:23:00Z
dc.date.issued	2020-01
dc.identifier.citation	BJOG: an International Journal of Obstetrics and Gynaecology, 2020, 127, (1), pp. 47-56
dc.identifier.issn	1470-0328
dc.identifier.issn	1471-0528
dc.identifier.uri	http://hdl.handle.net/10453/142918
dc.description.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 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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation	http://purl.org/au-research/grants/nhmrc/1024206
dc.relation.ispartof	BJOG: an International Journal of Obstetrics and Gynaecology
dc.relation.isbasedon	10.1111/1471-0528.15938
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Rheumatic Heart Disease
dc.subject.mesh	Pregnancy Complications, Cardiovascular
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Parity
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adult
dc.subject.mesh	Oceanic Ancestry Group
dc.subject.mesh	Income
dc.subject.mesh	Northern Territory
dc.subject.mesh	New Zealand
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Rheumatic Heart Disease
dc.subject.mesh	Pregnancy Complications, Cardiovascular
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Parity
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adult
dc.subject.mesh	Oceanic Ancestry Group
dc.subject.mesh	Income
dc.subject.mesh	Northern Territory
dc.subject.mesh	New Zealand
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.subject.mesh	Adult
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Income
dc.subject.mesh	New Zealand
dc.subject.mesh	Northern Territory
dc.subject.mesh	Oceanic Ancestry Group
dc.subject.mesh	Parity
dc.subject.mesh	Pregnancy
dc.subject.mesh	Pregnancy Complications, Cardiovascular
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Rheumatic Heart Disease
dc.subject.mesh	Young Adult
dc.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.
dc.type	Journal Article
utslib.citation.volume	127
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2020-09-29T06:22:53Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	127
utslib.citation.issue	1

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 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.

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http://hdl.handle.net/10453/142918