Predictors of maternal and fetal outcomes of pregnant women with mitral stenosis,A retrospective cross section study

BackgroundValvular heart disease, in particular mitral stenosis, is associated with unfavorable pregnancy outcomes. Data on maternal and fetal outcomes of pregnant women with mitral stenosis in Ethiopia as well as in other sub-Saharan countries is scare. Therefore the aim of this study was to assess the predictors of maternal and fetal outcomes of pregnant women with mitral valve stenosis and to show the incidence of maternal and fetal complications as well. MethodA retrospective cross section study was conducted. Medical records of pregnant women with mitral valve stenosis admitted at Tikur Anbessa Specialized Tertiary Referral hospital labor ward from January 2014 to December 2018 were reviewed. Data were entered and analyzed using SPSS version 25. Multivariate logistic regression analysis was used to evaluate associated factors. P-value of 0.05 was considered statistically significant. ResultThis study included 58 pregnant women with mitral stenosis. The mean age of the participants was 27(SD,{+/-}4.5) years. The mean mitral valve area among the participants was 1.1cm. About 79% of cases had mitral valve area of [≤]1.5cm2 and 55.2% had valve area of [≤]1cm2. Fifty one (87.9%) patients had moderate to severe pulmonary hypertension. The overall incidence of serious adverse pregnancy and peripartal outcome among the study participants was 44.8%. About 69% of patients had heart failure, from which 34.5% had NYHA class III and IV functional classes. Maternal death occurred in 4(6.9%) cases, whereas thromboembolism and ICU admission rates were 2(3.4%) and 3(5.2%) respectively. Neonatal complications including low birth weight, preterm delivery, abortions and still birth were 26.5%, 16%, 17.2% and 6.1% respectively. Mitral valve area was the main determinant factor for maternal and fetal outcomes of pregnant women with mitral stenosis (AOR=15, 2.50-90% CI, P=0.003). CONCLUSIONSThe overall incidence of serious adverse maternal and fetal events in pregnant mothers with mitral stenosis was 44.5%. Mitral valve area was the main determinant factor for maternal and fetal outcomes of pregnant women with mitral stenosis (AOR=15, 2.50-90% CI, P=0.003)