Dear Editor,
“In past 20 years, the world has made notable gains in the health of women and girls. Still, 800 women die each day due to preventable complications of pregnancy and childbirth. On #WomensDay, we reiterate our commitment to address the root causes of women’s and girl’s health disparities”. – Dr Tedros Adhanom Ghebreyesus, Director General of World Health Organization, Mar 8, 2023[1]
Prasad et al.[2] find a connection between cardiovascular disease in pregnancy and follow its outcomes in their prospective study in Nov 2023 issue of the Journal. The authors discovered 65 women with adverse effects, classified them into various groups, and made seven tables to present their results. Having gone through the tables, a reader can easily grasp the core findings of the study, and I am grateful to the authors for their Herculean efforts to convey their findings in such a simple manner. The table depicting the association between group and obstetric complications shows the relationship in a systematic way and I found it easy to make the association.
Nevertheless, there are a few points of wonder where I seek more information from the authors. The authors state the study period to be between January 2020 to December 2020. In this duration, the outcome of a few women in relation to their cardiovascular disease was studied and is published here as the authors state therein. However, the period was extraordinary in history of the mankind as that is related to COVID-19.[3] Rates of cesarean section are known to have increased during the pandemic.[4] So what is the effect of the pandemic on the small study group, I am perplexed. Whether anyone in the cohort contract the infection; and if yes, how many are the poser? Only then we may be able to decipher the aftereffects.[5] However, I am unable to find the crucial data therein.
COVID-19 infection is known to cause myocarditis and pericarditis.[6] So, whether some pregnant person developed the complication here, I want to know. Viral fevers are one of the most common causes of inflammation of cardiac tissue and SARS-CoV-2 is no exception. Therefore, I am looking for the prevalence of the known association here. Maternal mortality and complications extend up to 1 year after delivery and sometimes lead to morbidity and mortality.[7] So, in this study, what was the follow-up, and for how much duration, I am curious. By looking closely into the missing data, we may further extend our knowledge, examine the effects of the pandemic in a wider way, and be better prepared in the future should the next one arrive.
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Conflicts of interest
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References
- 1.Dr Tedros, on twitter. [[Last accessed on 2023 Dec 22]]. Available from: https://x.com/DrTedros/status/1633453514679541763?s=20 .
- 2.Prasad D, Prasad RV, Choudhary MK, Kumari K. Cardiovascular disease in pregnancy and its outcome: A prospective study. J Family Med Prim Care. 2023;12:2714–20. doi: 10.4103/jfmpc.jfmpc_507_23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Our World in Data. India: Coronavirus pandemic country profile. [[Last accessed on 2023 Dec 21]]. Available from: https://ourworldindata.org/coronavirus/country/india .
- 4.Silva CEBD, Guida JPS, Costa ML. Increased cesarean section rates during the COVID-19 pandemic: Looking for reasons through the robson ten group classification system. Rev Bras Ginecol Obstet. 2023;45:e371–6. doi: 10.1055/s-0043-1772182. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Mayo Clinic Staff. Pregnancy and COVID- 19: What are the risks? [[Updated on 2024 Apr 5]]. Available from: https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/pregnancy-and-covid-19/art-20482639 .
- 6.Fairweather D, Beetler DJ, Di Florio DN, Musigk N, Heidecker B, Cooper LT., Jr COVID-19, Myocarditis and pericarditis. Circ Res. 2023;132:1302–19. doi: 10.1161/CIRCRESAHA.123.321878. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Schrey-Petersen S, Tauscher A, Dathan-Stumpf A, Stepan H. Diseases and complications of the puerperium. Dtsch Arztebl Int. 2021;118:436–46. doi: 10.3238/arztebl.m2021.0168. [DOI] [PMC free article] [PubMed] [Google Scholar]