Publication:

Postpartum cardiovascular outcomes among pregnant women with known heart diseases

Background Maternal heart disease has emerged as a major threat to safe motherhood and women’s long-term cardiovascular health, and the postpartum period is a time of heightened risk for cardiovascular disease-related maternal morbidity and mortality. Therefore, the present study aimed to evaluate the effect of preconceptional counselling on postpartum cardiovascular outcomes among pregnant women with known heart disease in Bangladesh.

Methods This hospital-based cohort study was conducted at the Department of Obstetrics and Gynaecology, Fetomaternal Medicine Unit, Dhaka Medical College Hospital (DMCH); the Department of Fetomaternal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU); and the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from February 2020 to March 2021, including 73 postpartum women with heart disease. Demographic, obstetric, cardiac data, NYHA class, preconceptional counselling, and maternal outcomes were collected and analyzed using SPSS v26 (Chi-square, p<0.05).

Results Among 73 pregnant women (39 known, 34 incidentally diagnosed), younger age, lower socioeconomic status, education, and parity differed significantly between groups (p<0.001). LUCS was more frequent in known cases, vaginal delivery in incidental cases (p<0.001). Rheumatic heart disease predominated (41/73), and NYHA class I was higher in known cases (p<0.001). Cardiac events occurred in 45.2%, mostly in incidental cases (63.6% vs. 36.4%, p=0.010; RR=1.96), particularly in multiparas; outcomes did not vary by disease type.

Conclusions Awareness and early diagnosis of maternal heart disease, combined with timely multidisciplinary care, significantly reduce postpartum cardiovascular complications.