Reproductive journey in women with congenital heart disease: a systematic review of mental health implications.
No Thumbnail Available
Authors
Amato M.
Adeoye M.
Schofield R.
Di Cesare, M.
Contact
Check for full-text access
Issue Date
2026
Type
Article
Language
Keywords
Alternative Title
Abstract
ObjectivesAdvances in medical care have led to increased survival rates among individuals with congenital heart disease (CHD), enabling many women to pursue pregnancy and motherhood; however, their reproductive journey remains complex, involving intertwined medical and psychological challenges that are still not fully understood. This review aimed to explore the lived experiences of women with CHD as they navigate these reproductive challenges.DesignSystematic review of qualitative studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Critical Appraisal Skills Programme checklist was used for quality assessment.Data sourcesAPA PsycArticles, Medline Ultimate, APA PsycInfo, APA PsycTests and CINAHL Ultimate were searched on 10 March 2025.Eligibility criteriaStudies were included if they examined the lived experiences of women with CHD, focused on reproductive health, used qualitative methods and were published in English without time or geographical limits. Exclusion criteria were studies focusing on family members, men or healthcare professionals; reproductive health in other non-communicable diseases; acquired cardiac disease; single case studies; or quantitative designs.Data extraction and synthesisThe data extracted from qualitative studies included author(s), aims, location, design, method, analysis, results and clinical implications. The synthesis followed the Thomas and Harden thematic synthesis approach to answer the review question.ResultsEleven studies met the inclusion criteria. Thematic synthesis identified four analytical themes: (1) the need for psychological support in high-stakes decision-making, including the emotional burden of parenthood; (2) challenges of receiving conflicting medical guidance; (3) balancing reproductive autonomy with health risks, including the influence of social norms and comparisons with peers; and (4) the impact of geographical location on access to support.ConclusionsWomen with CHD face unique challenges within their reproductive health which is shaped by medical uncertainty, challenges with healthcare systems and high-stakes decision-making. Holistic care is crucial to support women through this journey and improve their outcomes. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.
Description
Citation
Publisher
License
Journal
BMJ Open
Volume
16