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Volume 16
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10.3390/life16020278
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Systematic Review

Impact of Cardiac Arrhythmias on Acute Maternal Cardiovascular Outcomes in Pregnancy: A Systematic Review and Meta-Analysis

by
Antonios Siargkas
1,†,
Alexandra Arvanitaki
2,†,
Areti Faka
1,
Efstratios Karagiannidis
3,
Barbara Fyntanidou
3,
Aikaterini Apostolopoulou
3,
Themistoklis Dagklis
1,
Apostolos Mamopoulos
1,
Antonios P. Antoniadis
2,
Nikolaos Fragakis
2,‡ and
Ioannis Tsakiridis
1,*,‡
1
3rd Department of Obstetrics and Gynecology, Ippokrateion General Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece
2
2nd Cardiology Department, Ippokrateion General Hospital, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece
3
Department of Emergency Medicine, Ahepa University Hospital, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
†
These authors shared first authorship to this work.
‡
These authors shared last authorship to this work.
Life 2026, 16(2), 278; https://doi.org/10.3390/life16020278
Submission received: 9 December 2025 / Revised: 11 January 2026 / Accepted: 28 January 2026 / Published: 5 February 2026
(This article belongs to the Special Issue Diagnosis and Management of Maternal Medical Diseases in Pregnancy: Current Practice and Future Perspectives)
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Abstract

Cardiac arrhythmias are prevalent complications in pregnancy, yet their precise association with acute maternal cardiovascular morbidity and mortality remains unclear due to heterogeneous evidence. This systematic review and meta-analysis evaluated the impact of maternal arrhythmias on acute cardiovascular outcomes. We searched Medline, Scopus, and Cochrane databases for observational studies comparing pregnant women with arrhythmias to those without. Random-effects meta-analyses were used to calculate pooled risk ratios (RR) for maternal mortality and major adverse cardiovascular events (MACE). Eleven studies comprising 76,028 pregnancies with arrhythmias and over 82 million controls were included. Analysis of data, primarily derived from large administrative cohorts with low absolute event rates, indicated that arrhythmias were significantly associated with increased all-cause maternal mortality (0.78% vs. 0.01%; RR 31.94; adjusted RR 8.91) and a composite of MACE (2.90% vs. 0.03%; RR 6.48). Supraventricular tachycardia and atrial fibrillation were associated with an increased likelihood of adverse outcomes. Notably, the relative risk of mortality and heart failure in women with arrhythmias versus controls was significantly higher in the general obstetric population around delivery than in women with known structural heart disease, suggesting a “sentinel event” phenomenon. Thromboembolic events were also 15 times more likely in the arrhythmia group. Cardiac arrhythmias during pregnancy are associated with substantial maternal morbidity and mortality. New-onset arrhythmias may warrant comprehensive cardiac evaluation, as they may unmask underlying pathology and precipitate severe hemodynamic compromise, particularly in women without prior cardiac history.
Keywords: pregnancy; cardiac arrhythmias; maternal mortality; major adverse cardiovascular events; systematic review; meta-analysis; cardio-obstetrics; atrial fibrillation; supraventricular tachycardia pregnancy; cardiac arrhythmias; maternal mortality; major adverse cardiovascular events; systematic review; meta-analysis; cardio-obstetrics; atrial fibrillation; supraventricular tachycardia

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MDPI and ACS Style

Siargkas, A.; Arvanitaki, A.; Faka, A.; Karagiannidis, E.; Fyntanidou, B.; Apostolopoulou, A.; Dagklis, T.; Mamopoulos, A.; Antoniadis, A.P.; Fragakis, N.; et al. Impact of Cardiac Arrhythmias on Acute Maternal Cardiovascular Outcomes in Pregnancy: A Systematic Review and Meta-Analysis. Life 2026, 16, 278. https://doi.org/10.3390/life16020278

AMA Style

Siargkas A, Arvanitaki A, Faka A, Karagiannidis E, Fyntanidou B, Apostolopoulou A, Dagklis T, Mamopoulos A, Antoniadis AP, Fragakis N, et al. Impact of Cardiac Arrhythmias on Acute Maternal Cardiovascular Outcomes in Pregnancy: A Systematic Review and Meta-Analysis. Life. 2026; 16(2):278. https://doi.org/10.3390/life16020278

Chicago/Turabian Style

Siargkas, Antonios, Alexandra Arvanitaki, Areti Faka, Efstratios Karagiannidis, Barbara Fyntanidou, Aikaterini Apostolopoulou, Themistoklis Dagklis, Apostolos Mamopoulos, Antonios P. Antoniadis, Nikolaos Fragakis, and et al. 2026. "Impact of Cardiac Arrhythmias on Acute Maternal Cardiovascular Outcomes in Pregnancy: A Systematic Review and Meta-Analysis" Life 16, no. 2: 278. https://doi.org/10.3390/life16020278

APA Style

Siargkas, A., Arvanitaki, A., Faka, A., Karagiannidis, E., Fyntanidou, B., Apostolopoulou, A., Dagklis, T., Mamopoulos, A., Antoniadis, A. P., Fragakis, N., & Tsakiridis, I. (2026). Impact of Cardiac Arrhythmias on Acute Maternal Cardiovascular Outcomes in Pregnancy: A Systematic Review and Meta-Analysis. Life, 16(2), 278. https://doi.org/10.3390/life16020278

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