Investigation of trends and outcomes in heart disease (HD) and pregnancy has been
limited. We chose to identify the prevalence, trends, and outcomes of pregnant women
with different forms of HD in the United States. Healthcare Cost and Utilization Project's
National Inpatient Sample was screened for hospital admissions for delivery in pregnant
women with HD from 2003 to 2012. Maternal clinical characteristics and outcomes were
identified in women with and without HD, and in HD subtypes: congenital (CHD), valvular
HD, cardiomyopathy, and pulmonary hypertension (PH). Primary outcomes of interest
were prevalence, trends, and major adverse cardiac events (MACEs), a composite of
in-hospital death, acute myocardial infarction, heart failure, arrhythmia, cerebrovascular
event, embolic events, or cardiac complications of anesthesia. We studied 81,295 patients
with HD and 39,894,032 without. CHD was the most frequent type (41.8%, 33,982 of 81,295
patients), followed by valvular HD (30.9%, 25,138 of 81,295 patients), cardiomyopathy
(20.8%, 16,926 of 81,295 patients), and PH (6.5%, 5,250 of 81,295 patients). MACE
was highest among women with cardiomyopathy and lowest among women with CHD (44.0%,
7,449 of 16,926 vs 6.2%, 2,102 of 33,982; p <0.0001). PH patients had the highest
in-hospital death, followed by cardiomyopathy patients (1.0%, 51 of 5,250 and 0.7%,
124 of 16,926, respectively). Pregnant women with HD significantly increased by 24.7%,
related to increases in cardiomyopathy, CHD, and PH from 2003 to 2012. MACE significantly
increased by 18.8%. In conclusion, pregnancy in women with HD is increasing, particularly
for high risk conditions such as cardiomyopathy and PH. There is a significant and
gradual increase in MACE for women with HD.
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Article Info
Publication History
Published online: February 28, 2017
Accepted:
February 6,
2017
Received in revised form:
February 6,
2017
Received:
November 7,
2016
Footnotes
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