Abstract 12660: Outcomes of Pregnancy-Associated Myocardial Infarction: A Systematic Review and Meta-Analysis

Background: Cardiovascular disease is the leading cause of maternal mortality worldwide. The aim of this systematic review and meta-analysis was to investigate complications associated with Pregnancy-associated myocardial infarction (PAMI), which has been linked to various obstetric and fetal complications.

Methods: We included a total of 11 studies which reported complications in women who had myocardial infarction (MI) during pregnancy. Our outcomes included maternal mortality, postpartum hemorrhage, postpartum infection, preterm labor, eclampsia and pre-eclampsia. Analysis was performed to calculate the pooled proportions. Data was pooled as mean differences or risk ratio and 95% confidence interval (CI) was used.

Results: Mortality was reported in 7.6% of women who had MI with effect estimate 0.189, 95% CI [0.113, 0.266] (Fig 1a). Incidence of postpartum hemorrhage was reported in 13% of women with effect estimate 0.143, 95% CI [0.060, 0.226] (Fig 1b) and postpartum infection was reported in 15.1% with effect estimate 0.269, 95% CI [0.030, 0.507]. Incidence of eclampsia and pre-eclampsia was reported in 10.98% with effect estimate 0.213, 95% CI [0.125, 0.301] (Fig 2a). Incidence of pre-term labor was reported in 12.87% with effect estimate 0.313, 95% CI [0.116, 0.510] (Fig 2b).

Conclusion: Our study demonstrated that PAMI was associated with higher rates of major obstetric complications including maternal mortality, postpartum hemorrhage, pre-term labor, pre-eclampsia, eclampsia and postpartum infection.