Abstract MP73: Cardiovascular Complications During Delivery Admissions Associated With Rheumatoid Arthritis: A National Inpatient Sample Analysis (2004-2019)

Abstract

Background: Individuals with rheumatoid arthritis (RA) have an increased risk of obstetric-associated complications as well as long term cardiovascular (CV) risk. However data on acute CV complications during pregnancy delivery remains limited. Methods: We used data from the National Inpatient Sample (2004-2019) utilizing ICD-9 or ICD-10 codes to identify delivery hospitalizations and a diagnosis of RA. Results: A total of 63,005,648 weighted delivery hospitalizations were identified, of which 0.1% were among persons with RA (n=62,402). Individuals with RA, vs those without, were older (median 31 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, RA remained an independent predictor of peripartum CV complications including preeclampsia (adjusted odds ratio (aOR) 1.41 [95% CI, 1.36-1.45]), peripartum cardiomyopathy (aOR 1.80 [1.38-2.35]), and cardiac arrhythmias (aOR 2.13 [1.98-2.29]) compared with no RA. Likewise, the risk of acute kidney injury (AKI), stroke, and venous thromboembolism (VTE) were higher with RA. An overall increasing trend of obesity and GDM was also observed among individuals with RA. For resource utilization, length of stay and cost of hospitalization was higher for deliveries among persons with RA. Conclusions: Pregnant individuals with RA had higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, AKI, stroke and VTE during delivery hospitalizations. Furthermore, cardiometabolic risk factors among pregnant individuals with RA rose over this 15 year period.