{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:49:07Z","timestamp":1784162947047,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["12\/698"],"award-info":[{"award-number":["12\/698"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001775","name":"University of Technology Sydney","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001775","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001801","name":"University of Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001801","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1024206"],"award-info":[{"award-number":["1024206"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the epidemiology of rheumatic heart disease (<jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content>) in pregnancy in Australia and New Zealand (A&amp;<jats:styled-content style=\"fixed-case\">NZ<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective population\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Hospital\u2010based maternity units throughout A&amp;<jats:styled-content style=\"fixed-case\">NZ<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Pregnant women with <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> with a birth outcome of \u226520\u00a0weeks of gestation between January 2013 and December 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified eligible women using the Australasian Maternity Outcomes Surveillance System (<jats:styled-content style=\"fixed-case\">AMOSS<\/jats:styled-content>). De\u2010identified antenatal, perinatal and postnatal data were collected and analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence of <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> in pregnancy. Perinatal morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 311 pregnancies associated with women with <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> (4.3\/10\u00a0000 women giving birth, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.9\u20134.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4\/10\u00a0000, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 50.7\u201370.0), while in New Zealand 90% were M\u0101ori or Pasifika (27.2\/10\u00a0000, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 22.0\u201332.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3\/1000 births) and two neonatal deaths (6.5\/1000 births). Sixty\u2010six (21%) live\u2010born babies were preterm and one in three was admitted to neonatal intensive care or special care units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&amp;<jats:styled-content style=\"fixed-case\">NZ<\/jats:styled-content>. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> screening in at\u2010risk pregnant women are essential for good maternal and baby outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15938","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T08:55:50Z","timestamp":1568278550000},"page":"47-56","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high\u2010income setting: a prospective cohort 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Centre for Public and Population Health Research Faculty of Health University of Technology Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Peek","sequence":"additional","affiliation":[{"name":"ANU Medical School College of Health and Medicine The Australian National University Canberra ACT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JR","family":"Carapetis","sequence":"additional","affiliation":[{"name":"Telethon Kids Institute The University of Western Australia Perth WA Australia"},{"name":"Perth Children's Hospital Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Walsh","sequence":"additional","affiliation":[{"name":"The University of New South Wales Sydney NSW Australia"},{"name":"Prince of Wales Hospital Sydney NSW 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