{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:59:48Z","timestamp":1788919188713,"version":"build-2803163510"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T00:00:00Z","timestamp":1483660800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Cardiac disease is one of the leading causes of indirect maternal death, and myocardial infarction (MI) is one of its most common aetiologies. The objectives of this systematic review and meta-analysis were to characterize the incidence of pregnancy-associated MI (PAMI), as well as the maternal mortality and the case-fatality rates due to PAMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Articles were obtained by searching electronic databases, bibliographies and conference proceedings with no language or date restrictions. Two reviewers independently selected population-based cohort and case-control studies reporting on incidence, mortality and case-fatality rates for pregnancy-associated MI. Meta-analysis was performed to estimate pooled maternal incidence, mortality and case-fatality rates. Meta-regression was performed to explore heterogeneity. Based on 17 included studies, the pooled incidence of PAMI and maternal mortality from PAMI were 3.34 (2.09\u20134.58) and 0.20 (0.10\u20130.29) per 100\u00a0000 pregnancies, respectively. The case-fatality rate was 5.03% (3.78\u20136.27%). Country\/region (meta-regression P = 0.006) and years of study (meta-regression P = 0.04) were potential explanations for the observed heterogeneity in the pooled incidence estimates of maternal MI and its associated mortality, with more recent studies and those conducted in the USA revealing the highest rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This article provides a global estimate of the incidence, mortality rate, and case fatality rate of pregnancy-associated MI. We identified higher rates of PAMI in the USA (relative to Canada and European countries) and rising rates over time. Further research regarding this population is needed, especially given rising maternal age and the increasing prevalence of cardiovascular risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcw060","type":"journal-article","created":{"date-parts":[[2016,12,2]],"date-time":"2016-12-02T20:07:03Z","timestamp":1480709223000},"page":"198-207","source":"Crossref","is-referenced-by-count":43,"title":["Incidence of myocardial infarction in pregnancy: a systematic review and meta-analysis of population-based studies"],"prefix":"10.1093","volume":"3","author":[{"given":"Paul","family":"Gibson","sequence":"first","affiliation":[{"name":"Departments of Medicine and Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Narous","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabassum","family":"Firoz","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research, World Health Organization, UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), 20 Avenue Appia, Geneva 1211, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Barreix","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research, World Health Organization, UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), 20 Avenue Appia, Geneva 1211, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lale","family":"Say","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research, World Health Organization, UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), 20 Avenue Appia, Geneva 1211, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"James","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Community Health Sciences, O\u2019Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the WHO Maternal Morbidity Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,1,5]]},"reference":[{"key":"2021011601343517500_qcw060-B1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/00001703-200312000-00002","article-title":"Pregnancy: a stress test for life","volume":"15","author":"Williams","year":"2003","journal-title":"Curr Opin Obstetr Gynecol"},{"key":"2021011601343517500_qcw060-B2","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1161\/CIRCULATIONAHA.114.009029","article-title":"Cardiovascular physiology of pregnancy","volume":"130","author":"Sanghavi","year":"2014","journal-title":"Circulation"},{"key":"2021011601343517500_qcw060-B3"},{"key":"2021011601343517500_qcw060-B4","volume-title":"Special Report on Maternal Mortality and Severe Morbidity in Canada","author":"Rusen","year":"2004"},{"key":"2021011601343517500_qcw060-B5","first-page":"1","article-title":"Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. 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