Comparison of Maternal and fetal outcomes in mothers with non-congenital mitral valve stenosis and healthy control

Background: Rheumatic mitral valve stenosis is the most common cardiac complication ofacute rheumatic fever. Heart valve disease and physiological changes during pregnancy causemore complications in pregnant women with mitral stenosis and their infants.Materials and methods: This study is a case-control study on the course of pregnancy anddelivery of ۱۵۳ pregnant women, including ۵۱ with mitral stenosis (MS) and ۱۰۲ without MSas the control group, between ۲۰۰۷-۲۰۲۲, who gave birth in Vali-e-Asr hospital in Birjand. Foreach studied patient, two control participants were selected at the same medical center,matching the patient in age, residence, and year of pregnancy. For the comparison of patientswith MS and controls, the Fisher exact test and Chi-square, and nonpaired t-test were used.SPSS version ۲۲ was used for data analysis.Results: The mean ± SD age was ۳۱.۷ ± ۴.۶ years in cases and ۳۱.۶±۴.۷ in the healthy controls(P-value = ۰.۸۶۵). Demographic variables were not significantly different between the caseand control groups. In terms of fetal outcomes, the rate of stillbirth (۵.۹% vs. ۰.۰%), %), NICUadmission (۱۳.۷% vs. ۲.۰%), and IUGR (۵.۹% vs. ۰.۰%) were higher in the case groupcompared with the control group. On the other hand, maternal outcomes, including pulmonaryedema (۱۳.۷% vs. ۰.۰%), ICU admission (۲۳.۵% vs. ۰.۰%), limb edema (۱۵.۷% vs. ۰.۰%),dyspnea (۳۷.۳% vs. ۰.۰%), pulmonary hypertension (۹.۸% vs. ۰.۰%), palpitations (۲۱.۱% vs.۰.۰%) and hospital admission during pregnancy (۳۷.۲% vs. ۴.۹%) were statistically morecommon in the case groups.Conclusions: In women with MS, pregnancy is associated with significant maternal and fetalmorbidities. The result of the present study highlights the need for preconception and neonatalcare of pregnant women with MS using a multidisciplinary approach involving obstetricians,cardiologists, and neonatologists.

Keywords:

Rheumatic mitral valve stenosis , high-risk pregnancy , maternal outcomes , fetal outcomes , case-control study