Objectives
To assess the frequency of maternal death (MD) due to cardiac disease in low- and middle-income countries (LMIC).
Methods
Systematic review searching Medline, EMBASE, Web of Science, Cochrane Library, Emcare, LILACS, African Index Medicus, IMEMR, IndMED, WPRIM, IMSEAR up to 01/Nov/2017. Maternal mortality reports from LMIC reviewing all MD in a given geographical area were included. Hospital-based reports or those solely based on verbal autopsies were excluded. Numbers of MD and cardiac-related deaths were extracted. We calculated cardiac disease MMR (cMMR, cardiac-related MD/100 000 live births) and proportion of cardiac-related MDs among all MDs. Frequency of cardiac MD was compared with the MMR of the country.
Results
Forty-seven reports were included, which reported on 38,486 maternal deaths in LMIC. Reported cMMR ranged from 0/100 000 live births (Moldova, Ghana) to 31.9/100 000 (Zimbabwe). The proportion of cardiac-related MD ranged from 0% (Moldova, Ghana) to 24.8% (Sri Lanka). In countries with a higher MMR, cMMR was also higher. However, the proportion of cardiac-related MD was higher in countries with a lower MMR.
Conclusions
The burden of cardiac-related mortality is difficult to assess due limited availability of mortality reports. The proportion of cardiac deaths among all MD appeared to be higher in countries with a lower MMR. This is in line with what has been called ‘obstetric transition’: pre-existing medical diseases including cardiac disease are becoming relatively more important where the MMR falls.
© 2020 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Overview publication
Title | Maternal mortality due to cardiac disease in low- and middle-income countries. |
Date | June 1st, 2020 |
Issue name | Tropical medicine & international health : TM & IH |
Issue number | v25.6:673-686 |
DOI | 10.1111/tmi.13386 |
PubMed | 32133737 |
Authors | |
Keywords | cardiac disease, low- and middle-income countries, maladie cardiaque, maternal mortality, mortalité maternelle, pays à revenu faible ou intermédiaire |
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