{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:33Z","timestamp":1747196133038,"version":"3.40.5"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background\/Aims<\/jats:title><jats:p>Maternal and infant morbidities associated with pregnant women with cardiac conditions are a global issue contingent upon appropriate care. This study aimed to describe the clinical variables and their association with the adherence scores to perinatal guidelines for pregnant women with cardiac conditions. The clinical variables included cardiac, perinatal, and neonatal outcomes and complications.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Using a retrospective cross-sectional medical record audit, data were abstracted and categorised as cardiac, obstetric, and neonatal predictors. Linear regression modelling was used to find the mean difference (MD) in adherence scores for each predictor, including a 95% confidence interval (CI) and a significance value for all the three categories\u2019 clinical outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>This maternal cohort\u2019s (n = 261) cardiac complications were primarily arrhythmias requiring treatment (29.9%), particularly SVT (28%), a new diagnosis of valvular heart disease and congenital heart disease (24%) and decompensated heart failure (HF) (16%). Women with HF had associated increased adherence scores (MD = 3.546, 95% CI: 1.689, 5.403) compared to those without HF. Elective LSCS mode of delivery was associated with a higher adherence score (MD = 5.197, 95% CI: 3.584, 6.811) than non-elective LSCS subgroups. Babies admitted to intensive \/special care had greater adherence to the guidelines (MD = 3.581, 95% CI: 1.822, 5.340) than those not requiring the same care.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Some pregnancy associated complications and morbidities were associated with higher adherence scores, reflecting that a diagnosis, identification of morbidities or risk factors, initiation of appropriate multidisciplinary involvement and adherence to guidelines were associated. Conversely, potentially avoidable major complications such as sepsis were associated with a low adherence score.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Trial registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=372394&amp;isReview=true\" xlink:type=\"simple\">ACTRN12617000417381<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0255070","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T17:29:54Z","timestamp":1627061394000},"page":"e0255070","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between guidelines adherence and clinical outcomes during pregnancy in a cohort of women with cardiac co-morbidities"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8108-8870","authenticated-orcid":true,"given":"Sandra","family":"Millington","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn A.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustaaf A.","family":"Dekker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Arstall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,7,23]]},"reference":[{"issue":"5","key":"pone.0255070.ref001","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/ejhf.501","article-title":"Global cardiac risk assessment in the Registry Of Pregnancy And Cardiac disease: results of a registry from the European Society of Cardiology","volume":"18","author":"IM van Hagen","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"pone.0255070.ref002","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/978-3-319-94171-4_18","volume-title":"Intensive Care of the Adult with Congenital Heart Disease","author":"L Baris","year":"2019"},{"issue":"00","key":"pone.0255070.ref003","first-page":"1","article-title":"Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)","author":"J Roos-Hesselink","year":"2019","journal-title":"Eur Heart J"},{"issue":"8","key":"pone.0255070.ref004","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1161\/CIRCULATIONAHA.118.036748","article-title":"Cardiovascular Disease-Related Morbidity and Mortality in Women With a History of Pregnancy Complications","volume":"139","author":"SM Grandi","year":"2019","journal-title":"Circulation"},{"journal-title":"AMOSS Prospective Longitudinal study for Cardiac Disease in Pregnancy","year":"2020","author":"E Sullivan","key":"pone.0255070.ref005"},{"issue":"1","key":"pone.0255070.ref006","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.hlc.2020.06.021","article-title":"Heart Disease and Pregnancy: The Need for a Twenty-First Century Approach to Care","volume":"30","author":"WA Parsonage","year":"2021","journal-title":"Heart, Lung and Circulation"},{"key":"pone.0255070.ref007","unstructured":"Welfare AIoH. 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