Abstract 12743: Risk of Cardiovascular Readmission Within 3 Years Following a Hypertensive Complication of Pregnancy

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Introduction: Women with pregnancies complicated by pregnancy-induced hypertension (PIH) have increased cardiovascular (CV) risk decades later. We sought to determine if these women demonstrate greater CV risk more immediately. Methods: Using administrative data, we extracted all hospital-based deliveries in the state of Florida from 2004 through 2013. Deliveries and clinical diagnoses were determined using ICD-9 CM codes. Readmissions to any Florida hospital were identified using unique patient identifiers. Our primary predictor was PIH, defined as a composite of gestational hypertension, pre-eclampsia, and eclampsia. Outcomes of interest were CV readmission, defined as a composite of myocardial infarction, stroke, or heart failure; non-CV readmission, and no readmission within 3 years of index delivery. Clinical profiles and maternal outcomes were stratified by readmission status. The association between risk of readmission and PIH was determined using logistic regression. Results: A total of 1,834,166 records from delivering mothers were included (mean age 27.3 ± 6.2 years; 53% white, 25% African American [AA], 20% Hispanic). There were 4,732 CV readmissions and 321,713 non-CV readmissions within 3 years of index delivery. When stratified by readmission status, there was a higher make-up of women with PIH in the CV readmission group compared with the other groups (16.5% CV readmission, 9.3% non-CV readmission, 7.4% no readmission; p<0.001) and a higher rate of obesity (13% CV readmission, 5% non-CV readmission, 3% no readmission; p<0.001). Sixty percent of women in the CV readmission group were AA. Women with PIH had a higher multivariate risk of both CV readmission (OR 1.71; 95% CI 1.48 - 1.86) and non-CV readmission (OR 1.08; 95% CI 1.07 - 1.10). Compared with white women, AA women had the highest risk for CV readmission (OR 3.39; 95% CI 3.17 - 3.63) and Hispanic women had the lowest risk of CV readmission (OR 0.60; 95% CI 0.53 - 0.67) after adjustment for PIH. Conclusion: In this diverse sample, women with PIH have a higher risk of CV readmission within 3 years of delivery. Significant racial and ethnic differences were seen in the risk for CV readmission among women with pregnancies complicated by PIH with a markedly higher risk in AA women.