{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T09:05:50Z","timestamp":1789117550035,"version":"build-2803163510"},"reference-count":35,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Cardiac disease is a leading non-obstetric cause of maternal morbidity and mortality, particularly in low- and middle-income countries.\nMethods:\u00a0Retrospective cross-sectional review of all deliveries from 01 January 2020 to 31 December 2022. Echocardiography-confirmed cardiac disease cases were identified. Data included demographics, lesion type and\/or severity (New York Heart Association [NYHA]), timing of diagnosis, delivery characteristics and outcomes. Associations were examined using \u03c72\u00a0and\u00a0t-tests (p\u00a0&lt; 0.05).\nResults:\u00a0Among 11 728 deliveries, 182 had cardiac disease (prevalence 1.6%, 95% CI: 1.34\u20131.80). Median age was 26 years (IQR 22\u201331); 50.6% presented with NYHA III\u2013IV. Rheumatic heart disease (RHD) predominated (61.5%), mainly mitral stenosis (43.8%) and mitral regurgitation (38.3%). Cardiomyopathy accounted for 31.3%; peripartum cardiomyopathy (PPCM) comprised 78.9% of cardiomyopathies, most diagnosed postpartum (64.9%) and frequently with Left Ventricular Ejection Fraction (LVEF) &lt; 45%. Preterm birth occurred in 46.9% of pregnancies, particularly with RHD\u2013MS (mean gestational age (GA) 33.0 \u00b1 6.0 weeks;\u00a0p\u00a0= 0.005). Caesarean delivery occurred in 72.0% (131\/182), mainly for obstetric (41.8%) rather than cardiac indications. Maternal complications were common (67.6%), including pulmonary oedema (28.6%, 95% CI: 22.1\u201335.7), pulmonary hypertension (13.2%, 95% CI: 8.6\u201319.0) and ICU admission (12.1%, 95% CI: 7.8\u201317.6). Maternal case fatality was 4.9% (9\/182; 95% CI: 2.3\u20139.2). Most neonates had favourable short\u2013term outcomes (5\u2013min Apgar \u2265 7 in 83.5%) and were discharged (87.7%).\nConclusion:\u00a0Rheumatic heart disease and PPCM were the dominant lesions and major drivers of severe morbidity and mortality.\nContribution:\u00a0The high burden of late presentation and severe functional limitation underscores the need for earlier detection, systematised cardio-obstetric care and strengthened primary prevention of RHD.<\/jats:p>","DOI":"10.4102\/jcmsa.v4i1.274","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:06:40Z","timestamp":1789114000000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, types, maternal and perinatal outcomes of cardiac disease in pregnancy at a tertiary Hospital in the Eastern Cape, South Africa"],"prefix":"10.4102","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9860-5843","authenticated-orcid":false,"given":"Sibusiso B.","family":"Mbili","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2888-9755","authenticated-orcid":false,"given":"Vulikhaya","family":"Mpumlwana","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8393-1198","authenticated-orcid":false,"given":"Charles B.","family":"Businge","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Balieva I, Chauke L, Wise A, et al. 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