The impact of pregnancy on bioprosthetic structural valve deterioration: a systematic review and meta-analysis.

Abstract

Objective: This systematic review and meta-analysis sought to assess the impact of pregnancy on bioprosthetic valve (BPV) structural valve deterioration. Methods: We searched Ovid MEDLINE, Scopus, Clinicaltrials.gov, and Cochrane Library from inception through October 17, 2022. We included all studies that compared patients with BPV with and without a pregnancy history. The initial search yielded 1748 unique citations that were screened in Covidence by two independent reviewers. Our outcome of interest was structural valve deterioration. Results: We performed random-effects meta-analyses from nine eligible studies. Meta-analysis of 321 individuals with a pregnancy history and 987 control individuals without pregnancy showed there was an increased odds in development of structural valve deterioration among those with a pregnancy history (OR 2.34, 95% CI 1.40-3.89) with an I ² of 59.8%. Conclusions: A pregnancy history was associated with an increased risk of structural valve deterioration; however, further research is needed due to the heterogeneity of results.