Abstract 9824: Cardiovascular Complications During Delivery Admissions Associated With Systemic Lupus Erythematosus: A National Inpatient Sample Analysis (2004-2019)

Abstract

Introduction: Persons with systemic lupus erythematosus (SLE) have an increased risk of obstetric-associated complications. However, data on acute cardiovascular (CV) complications during delivery remain limited. Hypothesis: SLE is associated with increased acute CV complications at the time of delivery. Methods: We used data from the National Inpatient Sample (2004-2019) while utilizing ICD-9 or ICD-10 codes to identify delivery hospitalizations and a diagnosis of SLE. Results: A total of 63,037,442 weighted delivery hospitalizations were identified, of which 0.1% were among persons with SLE (n=77,560). Individuals with SLE were older (median 30 vs. 28 years, p<0.01) and had a higher prevalence of polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM), obesity, and dyslipidemia (p<0.01). After adjustment for age, race/ethnicity, comorbidities, insurance, and income, SLE remained an independent predictor of peripartum CV complications including preeclampsia (aOR 2.12 [2.07-2.17]), peripartum cardiomyopathy (aOR 4.42 [3.79-5.13]), heart failure (aOR 4.06 [3.61-4.57]), and cardiac arrhythmias (aOR 2.06 [1.94-2.21]) compared with no SLE. Likewise, the risk of acute kidney injury (AKI), stroke, pulmonary edema and venous thromboembolism (VTE) were higher with SLE. An overall increasing trend of obesity, GDM and PCOS was also observed among individuals with SLE. For resource utilization, length of stay and cost of hospitalization was higher for deliveries among persons with SLE. Conclusions: Persons with SLE had a higher risk of preeclampsia, peripartum cardiomyopathy, heart failure, arrhythmias, pulmonary edema, AKI, stroke and VTE during delivery hospitalizations. Furthermore, cardiometabolic risk factors among individuals with SLE are on the rise over this 15 year period.