Antenatal experiences of pregnant women with cardiac conditions: a systematic review and meta-synthesis

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Objective: Cardiovascular conditions are the leading cause of maternal mortality in high-income countries. We aim to inform supportive care that addresses the needs of pregnant women with cardiac conditions. Data Sources: Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsychINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via Proquest were searched, database inception-June 2024. Study Eligibility Criteria: Studies with qualitative components describing experiences of pregnant women with any cardiac condition globally. Study Appraisal and Synthesis Methods: The Critical Appraisal Skills Programme checklist for qualitative research was employed to perform quality assessment. Inductive coding and thematic analysis were conducted using NVivo software. Results: Thirteen qualitative studies met the inclusion criteria for meta-synthesis. We identified 3 key themes pertaining to the pregnancy experience of women with cardiac conditions, including patient-provider risk perception matching, importance of communication, and peer influence. Women with established versus new cardiac diagnoses in pregnancy had differences in their experiences. Depending on their own perception of risk, women noted over-medicalization or dismissal by their providers. Our findings also showed that some women sought peer support through online support groups, which either provided a sense of community and hope, or were anxiety-inducing. Conclusions: It is critical for women and providers to have nuanced and personalized discussions about the risk of cardiac conditions during pregnancy. Experience of pregnancy differs amongst women with new or pre-existing cardiac conditions and is based on women's appraisal of their pregnancy's risk level. Reaching an agreement in risk perception is crucial to strengthen the patient-provider relationship and provide a basis for women to feel secure during their pregnancy.

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