Ronpichai ChokesuwattanaskulCharat ThongprayoonTarun BathiniOisin A. O'CorragainKonika SharmaSomchai PrechawatPatompong UngprasertKanramon WatthanasuntornPavida PachariyanonWisit CheungpasitpornTexas Tech University Health Sciences Center at LubbockTemple UniversityFaculty of Medicine, Siriraj Hospital, Mahidol UniversityUniversity of ArizonaMayo ClinicUniversity of Mississippi Medical CenterFaculty of Medicine, Chulalongkorn UniversityBassett Medical Center2020-01-272020-01-272019-09-01Advances in Medical Sciences. Vol.64, No.2 (2019), 415-42218984002189611262-s2.0-85072026929https://repository.li.mahidol.ac.th/handle/20.500.14594/51448© 2019 Medical University of Bialystok Purpose: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, and is associated with increased morbidity and mortality. However, the incidence and maternal/fetal outcomes of AF in pregnancy remain unclear. This study's aims were to investigate the pooled incidence of AF in pregnant women and to assess maternal/fetal outcomes of AF in pregnancy. Material and methods: A literature search for studies that reported incidence of AF in pregnancy, was conducted using MEDLINE, EMBASE and Cochrane Database from inception through May 2018. Pooled incidence with 95%CI were calculated using a random-effect model. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018095955). Results: We identified 7 cohort studies including 301,638 pregnancies. The pooled estimated incidence of AF in pregnancy among women with no known heart disease, and those with structural heart disease was 0.3% (95%CI: 0.01%–40.6%) and 2.2% (95%CI: 0.96%–5.01%), respectively. Among women with known AF, the pooled estimated incidence of recurrent AF in pregnancy was 39.2% (95%CI: 16.9%–67.2%). The pooled estimated incidence of pre-eclampsia and congestive heart failure among pregnant patients with AF was 4.1% (95%CI: 2.1%–7.8%) and 9.6% (95%CI: 5.7%–15.9%), respectively. The pooled estimated incidence of fetal events including premature birth, small for gestational age, respiratory distress syndrome, intraventricular hemorrhage, death was 26.6% (95%CI: 20.4%–34.0%). Conclusion: The overall estimated incidence of AF and recurrent AF during pregnancy is as high as 2.2% and 39.2%, respectively. AF during pregnancy may result in poor maternal and fetal outcomes.Mahidol UniversityMedicineReviewSCOPUS10.1016/j.advms.2019.07.003