Abstract MP46: The Associations Between Adverse Pregnancy Outcomes And Cardiovascular Delivery Complications: The National Inpatient Sample

Abstract

Background: Women with adverse pregnancy outcomes (APOs) are at increased risk of long-term cardiovascular (CV) disease, but less is known about the spectrum of acute CV outcomes in women with various APOs. We evaluated the risk of CV events at delivery in women with gestational diabetes (GDM), gestational hypertension and preeclampsia/eclampsia (PEC), overall and by race/ethnicity, in a US sample. Methods: We used the 2016-2017 National Inpatient Sample survey data from the Agency for Healthcare Research and Quality (AHRQ). ICD10-CM diagnosis codes were used to identify women with a delivery hospitalization and to identify CV outcomes. We examined demographics and prevalence of CV events at delivery by the 3 APOs. Logistic regression was used to determine risk of various adverse CV events at delivery by APO, adjusted for age, income and hospital location. To generate national estimates, sampling weights provided by AHRQ were used. Results: Among 3,776,531 deliveries in 2016-2017, GDM was the most common APO (n=552,975; 7.3%). GDM occurred more frequently in Hispanics and Asians/Pacific Islanders (23% and 11%, respectively), while PEC occurred more frequently in Blacks (20%). While there was greater occurrence of CV events with all 3 APOs, after adjustment, only PEC was significantly associated with increased odds of adverse CV events [peripartum cardiomyopathy: OR 3.87 (95% CI 3.30-4.55), congestive heart failure: OR 4.04 (3.52-4.63), acute ischemic heart disease: OR 3.67 (2.65-5.08) and arrhythmias: OR 1.39 (1.22-1.59)]. Risk was elevated for Whites, Blacks, Hispanics and Asians/Pacific Islanders, although there was heterogeneity of the magnitude of risk by race/ethnicity ( Table ). Discussion: Women with APOs, especially PEC, are more likely to experience acute CV complications at hospital delivery than women without APOs. While Black women are more likely to develop PEC, women of all race/ethnicities with PEC are at risk of CV complications.