Abstract 13230: Prevalence, Trends, and Outcomes of Cardiovascular Diseases in Pregnant Patients in the United States: 2010 to 2019

Abstract

Introduction: Contemporary data on the prevalence, trends, and outcomes of cardiovascular diseases (CVD) in pregnant patients are limited. Hypothesis: We aimed to analyze the prevalence, trends, and outcomes of CVD and their subtypes in hospitalized pregnant patients in the United States (U.S.). Methods: This retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients from January 1, 2010, to December 31, 2019. Pregnancy-associated hospitalizations were identified, and patients with missing information on the length of stay (LOS) and mortality were excluded. Main outcomes were prevalence and trend of CVD burden in pregnant patients. Results: 39,212,104 hospitalized pregnant patients were identified: 4,409,924 with CVD (11.25%) and 34,802,180 without CVD (88.75%). The annual CVD burden increased from 9.49 % in 2010 to 15.54 % 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. Trends of all CVD subtypes increased; however, the trend of valvular heart disease decreased. In-hospital mortality was 8.2/10,00 in CVD but its trend decreased from 8.9/10,000 in 2010 to 7.4/10,000 in 2019 (p<0.001). CVD was associated with higher odds of mortality compared with non-CVD patients (odds ratio (OR): 32.7, 95% CI 28.8-37.1, 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). Conclusions: Overall CVD burden is high among pregnant patients with a significant uptrend of CVDs from 2010 to 2019 in the U.S. CVD burden was associated with higher in-hospital mortality, and 6-week postpartum all-cause readmission, myocardial infarction, and stroke. However, mortality among CVD patients decreased from 2010 to 2019 in the U.S.