Int J Cardiol. 2026 Sep 14:134782. doi: 10.1016/j.ijcard.2026.134782. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiac disease complicating pregnancy is a major contributor to maternal morbidity and mortality worldwide, particularly in low- and middle-income countries where access to specialized care remains limited. Data from Eastern Indonesia are scarce, limiting effective risk stratification and health system planning. This study aimed to establish a prospective regional registry describing the burden, clinical spectrum, and outcomes of cardiac disease in pregnancy in a tertiary referral center.
METHODS: A prospective descriptive registry was conducted at Regional General Hospital (RSUD) Provinsi Nusa Tenggara Barat, Indonesia, from September 2023 to August 2024. All pregnant women diagnosed with cardiac disease during pregnancy were consecutively enrolled. Maternal demographic characteristics, obstetric history, cardiac diagnoses, comorbidities, and maternal-fetal outcomes were collected and analyzed descriptively.
RESULTS: Among 1023 pregnant women managed during the study period, 39 (3.8%) were diagnosed with cardiac disease. Most patients were multigravida, with third pregnancies being the most common (30.8%). Valvular heart disease was present in 18.0% of cases, predominantly involving the mitral valve. Cardiac arrhythmias occurred in 23.1%, including atrial fibrillation and supraventricular tachycardia. Hypertension was the most frequent cardiovascular comorbidity (30.8%). Heart failure developed in 25.6% of patients. Maternal in-hospital mortality was 10.3%, while 17.9% of pregnancies resulted in preterm birth.
CONCLUSION: Cardiac disease in pregnancy in Eastern Indonesia is associated with a high burden of maternal and neonatal complications, including heart failure, preterm birth, and substantial maternal mortality. These findings highlight the urgent need for structured cardio-obstetric services, early risk stratification, and preconception counseling. Regional prospective registries play a crucial role in informing context-specific strategies to reduce preventable adverse outcomes in resource-limited settings.
PMID:42735847 | DOI:10.1016/j.ijcard.2026.134782
