Pregnancy Outcomes and Associated Factors in Women with Cardiovascular Diseases

Background: Worldwide, cardiovascular diseases are among the leading cause of death, representing about a third of all global deaths. Of these deaths, 85% were due to heart attack and stroke. While existing evidences reveal that pregnancy in women with cardiovascular disease is associated with a range of feto-maternal complications, corresponding studies among pregnant women in Ethiopian context are rather limited. Thus, the aim of this study was to assess pregnancy outcomes and associated factors in women with cardiovascular diseases. Methods: : An institution-based cross-sectional study was conducted among 384 pregnant women with cardiovascular disease attending three selected public hospitals of Addis Ababa, Ethiopia. Women’s charts were selected with multi-stage sampling technique. The collected data was entered and analyzed using Statistical package for Social Science version 26. Descriptive and inferential statistics were used to analyze the data. A p value of <0.05 was predetermined to be statistically significant for multivariable logistic regression. Result: Two-thirds (255;66.4%) of the pregnant mothers were younger than 36 years. More than half (202;52.6%) had valvular heart disease and about a third (116;30.2%) had heart failure. There were 25.5% heart failure events and 18.7% life threatening arrhythmia episodes. Two hundred fifty-four (66.1%) of the cohort had poor pregnancy outcomes such as preterm delivery (39.6%), abortion (15.6%) and stillbirth (8.3%) of the pregnancies. 8.1% of the pregnancies ended with maternal death. Women with valvular heart disease (AOR=3.418, 95% CI =2.045-5.714) and heart failure (AOR =5.058, 95% CI=2.641-9.687) were more likely to have poor pregnancy outcome. Conclusion: Pregnancy in women with CVD is a serious cause of maternal mortality and morbidity in the study setting. These women should receive strict clinical attention by a multidisciplinary team both during preconception and prenatal period to improve feto-maternal outcomes.