Journal article
Maternal mortality due to cardiac disease in low‐ and middle‐income countries
- Abstract:
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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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Publisher copy:
- 10.1111/tmi.13386
Authors
- Publisher:
- Wiley
- Journal:
- Tropical Medicine and International Health More from this journal
- Volume:
- 25
- Issue:
- 6
- Pages:
- 673-686
- Publication date:
- 2020-03-22
- Acceptance date:
- 2020-03-04
- DOI:
- EISSN:
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1365-3156
- ISSN:
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1360-2276
- Pmid:
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32133737
- Language:
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English
- Keywords:
- Pubs id:
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1092949
- Local pid:
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pubs:1092949
- Deposit date:
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2020-03-17
Terms of use
- Copyright holder:
- Heemelaar et al.
- Copyright date:
- 2020
- Rights statement:
- © 2020 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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