Abstract 18072: Effect of Pregnancy on Structural Valve Deterioration of Bioprosthetic Valves: a Systematic Review and Meta-analysis
Background: In the 1980s case series suggested that pregnancy may hasten structural valve deterioration (SVD) of bioprosthesis; however, later studies have had discordant results. We conducted a meta-analysis to determine if SVD is more common in women who become pregnant after bioprosthesis implantation and identify predictors of this association.
Methods: Using the search terms “structural valve deterioration”, “structural valve degeneration”, and “pregnancy”, MEDLINE, EMBASE, CINAHL, and Cochrane Library databases were reviewed from inception till October 2013. Cohort and case control studies assessing SVD in women of childbearing age with bioprosthesis were included. We calculated the relative risk (RR) and 95% confidence interval (CI) of having SVD by pregnancy status using the DerSimonian-Laird method. Meta-regression examined the RR of SVD by age, number of pregnancies and time from valve replacement to delivery.
Results: Our search strategy yielded 23 articles; 7 studies met our selection criteria, including a total of 856 patients. Group 1 consisted of 234 women who had been pregnant and Group 2 of 622 who had not. The RR of having SVD of Group 1 was 1.73; 95% CI 1.22-2.43; p<0.01 (Figure). None of the factors evaluated in meta-regression were statistically significant, however less pregnancies and less time from replacement to delivery had a trend towards significance.
Conclusion: Pregnancy does increase the risk of SVD. Pregnancy in women with bioprosthesis is carried out with increased risk of morbidity related to the implanted valve.
Author Disclosures: J. Munoz-Mendoza: None. V.A. Pinto Miranda: None. L.J. Tamariz: None. C.E. Mendoza: None.
- © 2014 by American Heart Association, Inc.