Pregnancy outcomes in women with heart disease: the Madras Medical College Pregnancy And Cardiac (M-PAC) Registry from India
Authors' conclusion
Maternal mortality is high in PWWHD from India. Highest death rates occurred in women with PHVs, PH and LVSD.
Study context
- Population
- Pregnant women with heart disease, Tamil Nadu, India, July 2016–December 2019
- Participants
- 1,005 women1,029 pregnancies
- Outcome
- Maternal mortality and composite maternal cardiac events (MCEs)
Methodological detailsconsecutive pregnancies, prospective enrolment
- Consecutive pregnancies
- Prospective enrolment
Main finding
As reported in the abstract
Maternal cardiac events (MCEs) (pregnancies)
15.2%
156/1029; 95% CI: 13.0–17.5
Maternal mortality
1.9%
20/1029; 95% CI: 1.1–2.8
Observational data: associations, not effects.
Secondary outcomes
HF as MCE
- HF, most common MCE
- 66.0% (103/156; 95% CI: 58.0-73.4)
Maternal mortality with prosthetic heart valves
- Maternal mortality, PHVs (highest)
- 8.6% (6/70)
Independent predictors of MCE
- LV systolic dysfunction, PHVs, severe mitral stenosis, pulmonary hypertension and heart disease (HD) diagnosed in current pregnancy independently predicted MCE
Modified WHO (mWHO) classification c-statistic
- C-statistic for MCE
- 0.794 (95% CI: 0.763-0.826)
- C-statistic for maternal death
- 0.796 (95% CI: 0.732-0.860)
Live births
- Pregnancies resulting in live births
- 91.2% (938/1029)
Adverse foetal events
- Pregnancies with adverse foetal events (AFEs)
- 33.7% (347/1029; 95% CI: 30.8-36.7)
Original publication
Pregnancy outcomes in women with heart disease: the Madras Medical College Pregnancy And Cardiac (M-PAC) Registry from India. Eur Heart J. Published 3 February 2023. doi:10.
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