Maternal arrhythmias are increasingly encountered in pregnancy with advancing maternal age, yet their clinical implications have remained inconsistently defined. A systematic review and meta-analysis of 19 studies now provides clarity, showing that maternal arrhythmias are associated with adverse maternal and fetal outcomes across multiple domains.

The analysis, published in Healthcare and conducted using PRISMA guidelines, evaluated cohort and case-control studies identified through MEDLINE, Scopus, and Cochrane on November 4, 2025. Pregnant women with cardiac arrhythmias were compared with those without, with data pooled using random-effects models and subgroup analyses by arrhythmia type. Primary outcomes included preeclampsia, stillbirth, preterm delivery, and small-for-gestational-age (SGA) neonates.

Pooled results showed higher risks of preeclampsia (RR 1.46; 95% CI 1.10-1.93), preterm delivery (RR 1.39; 95% CI 1.12-1.72), and stillbirth (RR 2.09; 95% CI 1.11-3.91) in women with arrhythmias. Risk patterns differed by arrhythmia subtype. Ventricular tachycardia or fibrillation was associated with stillbirth (RR 4.20; 95% CI 3.75-4.71) and neonatal death (RR 15.47; 95% CI 3.45-69.45), while supraventricular tachycardia (SVT) was associated with preeclampsia (adjusted RR 1.14; 95% CI 1.04-1.24), preterm delivery (adjusted RR 1.76; 95% CI 1.39-2.23), and SGA neonates (adjusted RR 5.93; 95% CI 1.23-28.55).

Risk estimates were higher in women without known heart disease compared with those with preexisting disease. These findings suggest that maternal arrhythmias are associated with adverse pregnancy outcomes and may serve as markers of increased fetal risk, supporting closer clinical monitoring.