Abstract 13863: Incidence and Clinical Significance of Cardiac Arrhythmias During Labor

Abstract

Introduction: Physiologic changes during pregnancy can predispose mothers to new-onset cardiac arrhythmia. Women with a history of cardiac arrhythmia are at increased risk of recurrence or worsening of previously identified conditions. Previous studies have demonstrated that women with heart disease are at increased risk of maternal morbidity and mortality. However, few studies have explored the prevalence and clinical significance of maternal arrhythmias specifically. Objectives: The objectives of this study are to define the prevalence of arrhythmias in pregnancy and labor, identify risk factors for having such arrhythmias in patients both with and without prior history of cardiac arrhythmia, and examine the association between cardiac arrhythmias and adverse maternal outcomes. Methods: The medical records of patients admitted for delivery to any of the 13 hospitals in Northwell Health utilizing the electronic medical records from Jan 2012 - Dec 2020 were reviewed to identify patients with a history or current diagnosis of cardiac arrhythmia. Outcomes including Cesarean section, length of stay (LOS), infant requiring care in the neonatal intensive care unit (NICU) were evaluated between the arrhythmia group and a subset of deliveries without arrhythmias (controls). Results: Out of 141,772 patients, 88 were identified with a history of and/or current SVT and 87 were compared with 334 controls. The sample had mean age 31.7 ± 5.2 years, median length of stay 3 days (IQR 2-3), and median parity 2 (IQR 1-2). When adjusting for age and parity, logistic regression showed SVT was significantly associated with C-section (OR 1.9, CI 1.1-3.1, AUC 0.69 p=0.01). Fisher’s exact test showed SVT was associated with admission to NICU (p=0.03). Cox proportional hazards regression found SVT was not associated with LOS (HR 0.8, CI 0.6-1.0, p=0.06) when adjusted for age and parity. Conclusion: A history of SVT and/or current SVT during labor was associated with C-sections and NICU admissions but was not associated with LOS. These findings may help guide treatment strategies for this patient population.