Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease.

Détails

ID Serval
serval:BIB_6099D36ABA18
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease.
Périodique
Heart
Auteur(s)
van Hagen I.M., Baart S., Fong Soe Khioe R., Sliwa-Hahnle K., Taha N., Lelonek M., Tavazzi L., Maggioni A.P., Johnson M.R., Maniadakis N., Fordham R., Hall R., Roos-Hesselink J.W., Bouchardy Judith, Rutz Tobias
Collaborateur(s)
ROPAC investigators
ISSN
1468-201X (Electronic)
ISSN-L
1355-6037
Statut éditorial
Publié
Date de publication
05/2018
Peer-reviewed
Oui
Volume
104
Numéro
9
Pages
745-752
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.
The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country).
A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.
While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.
Mots-clé
Adult, Analysis of Variance, Female, Global Health, Heart Diseases/epidemiology, Humans, Maternal Age, Pregnancy, Pregnancy Complications, Cardiovascular/epidemiology, Pregnancy Outcome/epidemiology, Prospective Studies, Registries, Residence Characteristics/statistics & numerical data, Socioeconomic Factors, congenital heart disease, global health, heart failure, pregnancy, valvular heart disease
Pubmed
Web of science
Création de la notice
20/09/2019 15:14
Dernière modification de la notice
04/09/2021 6:35
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