Prevalence, trends, and outcomes of cardiovascular diseases in pregnant patients in the USA: 2010–19

Author:

Majmundar Monil1ORCID,Doshi Rajkumar2,Patel Kunal N3ORCID,Zala Harshvardhan4,Kumar Ashish5,Kalra Ankur6ORCID

Affiliation:

1. Department of Cardiology, University of Kansas Medical Center , Kansas, KS , USA

2. Department of Cardiology, St. Joseph’s University Medical Center , Paterson, NJ , USA

3. Department of Internal Medicine, Saint Peter’s University Hospital , New Brunswick, NJ , USA

4. Department of Clinical Research, Icahn School of Medicine at Mount Sinai , New York, New York , USA

5. Department of Internal Medicine, Cleveland Clinic Akron General , Akron, OH , USA

6. Franciscan Health Lafayette East , 3900 St. Francis Way, Ste 200, Lafayette, IN 47905 , USA

Abstract

AbstractAimsContemporary data on the prevalence, trends, and outcomes of cardiovascular diseases (CVDs) in pregnant patients are limited. This study aimed to analyse the prevalence, trends, and outcomes of CVD and their subtypes in hospitalized pregnant patients in the USA.Methods and resultsThis retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients from 1 January 2010, to 31 December 2019. Data analyses were conducted from January to February 2022. Pregnancy-associated hospitalizations were identified. The main outcomes were the prevalence and trend of CVD in pregnant patients. 39 212 104 hospitalized pregnant patients were identified: 4 409 924 with CVD (11.3%) and 34 802 180 without CVD (88.8%). The annual age-adjusted CVD prevalence increased from 9.2% in 2010 to 14.8% in 2019 (P < 0.001). Hypertensive disorder of pregnancy (1069/10 000) was the most common, and aortic dissection (0.1/10 000) was the least common CVD. The trends of all CVD subtypes increased; however, the trend of valvular heart disease decreased. Age-adjusted in-hospital all-cause mortality was 8.2/10 000 in CVD, but its trend decreased from 8.1/10 000 in 2010 to 6.5/10 000 in 2019 (P < 0.001). CVD was associated with 15.51 times higher odds of in-hospital all-cause mortality compared with non-CVD patients [odds ratio (OR): 15.51, 95% confidence interval (CI)13.22–18.20, P < 0.001]. CVD was associated with higher 6-week postpartum readmission (OR: 1.97, 95% CI: 1.95–1.99), myocardial infarction (OR: 3.04, 95% CI: 2.57–3.59), and stroke (OR: 2.66, 95% CI: 2.41–2.94)(P < 0.001 for all).ConclusionThere is an increasing age-adjusted trend in overall CVD and its subtypes among pregnant patients in the USA from 2010 to 2019. Pregnant patients with CVD had higher odds of in-hospital mortality than those without CVD. However, in-hospital all-cause mortality among patients with and without CVD has decreased over the past 10 years. CVD was associated with higher 6-week postpartum all-cause readmission, myocardial infarction, and stroke rates.

Funder

Ram and Sanjita Kalra Aavishqaar Fund.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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