The burden of antenatal heart disease in South Africa: a systematic review

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dc.contributor.authorWatkins, Daviden_ZA
dc.contributor.authorSebitloane, Motshedisien_ZA
dc.contributor.authorEngel, Mark Een_ZA
dc.contributor.authorMayosi, Bonganien_ZA
dc.date.accessioned2015-11-23T12:08:58Z
dc.date.available2015-11-23T12:08:58Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: Maternal mortality in South Africa is rising, and heart conditions currently account for 41 per cent of indirect causes of deaths. Little is known about the burden of heart disease in pregnant South Africans. METHODS: We systematically reviewed the contemporary epidemiology and peripartum outcomes of heart disease in South African women attending antenatal care. Searches were performed in PubMed, ISI Web of Science, the EBSCO Africa-Wide database, the South African Union Catalogue, and the Current and Completed Research database (South Africa). References of included articles were also hand-searched. Studies reporting epidemiologic data on antenatal heart disease in South Africa were included. Data on morbidity and mortality were also collected. RESULTS: Seven studies were included in the systematic review. The prevalence of heart disease ranged from 123 to 943 per 100,000 deliveries, with a median prevalence of 616 per 100,000. Rheumatic valvular lesions were the commonest abnormalities, although cardiomyopathies were disproportionately high in comparison with other developing countries. Peripartum case-fatality rates were as high as 9.5 per cent in areas with limited access to care. The most frequent complications were pulmonary oedema, thromboembolism, and major bleeding with warfarin use. Perinatal mortality ranged from 8.9 to 23.8 per cent, whilst mitral lesions were associated with low birth weight. Meta-analysis could not be performed due to clinical and statistical heterogeneity of the included studies. CONCLUSION: Approximately 0.6 per cent of pregnant South Africans have pre-existing cardiac abnormalities, with rheumatic lesions being the commonest. Maternal and perinatal morbidity and mortality continue to be very high. We conclude this review by summarising limitations of the current literature and recommending standard reporting criteria for future reports.en_ZA
dc.identifier.apacitationWatkins, D., Sebitloane, M., Engel, M. E., & Mayosi, B. (2012). The burden of antenatal heart disease in South Africa: a systematic review. <i>BMC Cardiovascular Disorders</i>, http://hdl.handle.net/11427/15252en_ZA
dc.identifier.chicagocitationWatkins, David, Motshedisi Sebitloane, Mark E Engel, and Bongani Mayosi "The burden of antenatal heart disease in South Africa: a systematic review." <i>BMC Cardiovascular Disorders</i> (2012) http://hdl.handle.net/11427/15252en_ZA
dc.identifier.citationWatkins, D. A., Sebitloane, M., Engel, M. E., & Mayosi, B. M. (2012). The burden of antenatal heart disease in South Africa: a systematic review. BMC cardiovascular disorders, 12(1), 23.en_ZA
dc.identifier.ris TY - Journal Article AU - Watkins, David AU - Sebitloane, Motshedisi AU - Engel, Mark E AU - Mayosi, Bongani AB - BACKGROUND: Maternal mortality in South Africa is rising, and heart conditions currently account for 41 per cent of indirect causes of deaths. Little is known about the burden of heart disease in pregnant South Africans. METHODS: We systematically reviewed the contemporary epidemiology and peripartum outcomes of heart disease in South African women attending antenatal care. Searches were performed in PubMed, ISI Web of Science, the EBSCO Africa-Wide database, the South African Union Catalogue, and the Current and Completed Research database (South Africa). References of included articles were also hand-searched. Studies reporting epidemiologic data on antenatal heart disease in South Africa were included. Data on morbidity and mortality were also collected. RESULTS: Seven studies were included in the systematic review. The prevalence of heart disease ranged from 123 to 943 per 100,000 deliveries, with a median prevalence of 616 per 100,000. Rheumatic valvular lesions were the commonest abnormalities, although cardiomyopathies were disproportionately high in comparison with other developing countries. Peripartum case-fatality rates were as high as 9.5 per cent in areas with limited access to care. The most frequent complications were pulmonary oedema, thromboembolism, and major bleeding with warfarin use. Perinatal mortality ranged from 8.9 to 23.8 per cent, whilst mitral lesions were associated with low birth weight. Meta-analysis could not be performed due to clinical and statistical heterogeneity of the included studies. CONCLUSION: Approximately 0.6 per cent of pregnant South Africans have pre-existing cardiac abnormalities, with rheumatic lesions being the commonest. Maternal and perinatal morbidity and mortality continue to be very high. We conclude this review by summarising limitations of the current literature and recommending standard reporting criteria for future reports. DA - 2012 DB - OpenUCT DO - 10.1186/1471-2261-12-23 DP - University of Cape Town J1 - BMC Cardiovascular Disorders LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - The burden of antenatal heart disease in South Africa: a systematic review TI - The burden of antenatal heart disease in South Africa: a systematic review UR - http://hdl.handle.net/11427/15252 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15252
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2261-12-23
dc.identifier.vancouvercitationWatkins D, Sebitloane M, Engel ME, Mayosi B. The burden of antenatal heart disease in South Africa: a systematic review. BMC Cardiovascular Disorders. 2012; http://hdl.handle.net/11427/15252.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Watkins et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Cardiovascular Disordersen_ZA
dc.source.urihttp://www.biomedcentral.com/bmccardiovascdisord/en_ZA
dc.subject.otherheart diseaseen_ZA
dc.subject.otherSouth African womenen_ZA
dc.subject.otherpregnant South Africansen_ZA
dc.subject.otherMaternal mortalityen_ZA
dc.titleThe burden of antenatal heart disease in South Africa: a systematic reviewen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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