Rheumatoid arthritis and cardiovascular complications during delivery: a United States inpatient analysis

Department

Internal Medicine

Additional Department

Rheumatology

Document Type

Article

Publication Title

European Heart Journal

Abstract

Background and aims: Persons with rheumatoid arthritis (RA) have an increased risk of obstetric-associated complications, as well as long-term cardiovascular (CV) risk. Hence, the aim was to evaluate the association of RA with acute CV complications during delivery admissions.

Methods: Data from the National Inpatient Sample (2004-2019) were queried utilizing ICD-9 or ICD-10 codes to identify delivery hospitalizations and a diagnosis of RA.

Results: A total of 12 789 722 delivery hospitalizations were identified, of which 0.1% were among persons with RA (n = 11 979). Individuals with RA, vs. those without, were older (median 31 vs. 28 years, P < .01) and had a higher prevalence of chronic hypertension, chronic diabetes, gestational diabetes mellitus, obesity, and dyslipidaemia (P < .01). After adjustment for age, race/ethnicity, comorbidities, insurance, and income, RA remained an independent risk factor for peripartum CV complications including preeclampsia [adjusted odds ratio (aOR) 1.37 (95% confidence interval 1.27-1.47)], peripartum cardiomyopathy [aOR 2.10 (1.11-3.99)], and arrhythmias [aOR 2.00 (1.68-2.38)] compared with no RA. Likewise, the risk of acute kidney injury and venous thromboembolism was higher with RA. An overall increasing trend of obesity, gestational diabetes mellitus, and acute CV complications was also observed among individuals with RA from 2004-2019. For resource utilization, length of stay and cost of hospitalization were higher for deliveries among persons with RA.

Conclusions: Pregnant persons with RA had higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, and venous thromboembolism during delivery hospitalizations. Furthermore, cardiometabolic risk factors among pregnant individuals with RA rose over this 15-year period.

First Page

1524

Last Page

1536

DOI

10.1093/eurheartj/ehae108

Volume

45

Issue

17

Publication Date

5-7-2024

Medical Subject Headings

Humans; Female; Pregnancy; United States (epidemiology); Adult; Arthritis, Rheumatoid (epidemiology, complications); Hospitalization (statistics & numerical data); Pregnancy Complications, Cardiovascular (epidemiology); Cardiovascular Diseases (epidemiology); Risk Factors; Delivery, Obstetric (adverse effects, statistics & numerical data); Pregnancy Complications (epidemiology)

PubMed ID

38427130

Link to Full Text

Share

COinS