Cardiomyopathies in Pregnancy: Trends and Clinical Outcomes in Delivery Hospitalizations in the United States (2005-2020)

Danish Iltaf Satti, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Eunjung Choi, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Harsh P. Patel, Department of Cardiology, Southern Illinois University School of Medicine, Springfield, IL, USA.
Mohammed Faisaluddin, Rochester Regional HealthFollow
Adhya Mehta, Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Bhavin Patel, Department of Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, MI, USA.
Chigolum Pamela Oyeka, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Shruti Hegde, Department of Cardiology, Southern Illinois University School of Medicine, Springfield, IL, USA.
Yaa Adoma Kwapong, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Jeffrey Shi Chan, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
Shannon Anderson, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Nasrien E. Ibrahim, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Shashank S. Sinha, Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
Sourbha S. Dani, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
Garima Sharma, Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Current Problems in Cardiology

Abstract

BACKGROUND: Cardiomyopathy (CDM) in pregnancy is associated with maternal morbidity and mortality.

OBJECTIVES: To explore trends and clinical outcomes in CDM subtypes during delivery hospitalizations.

METHODS: We used the National Inpatient Sample database to identify delivery hospitalizations between 2005-2020 by CDM subtypes: peripartum (PPCM), dilated (DCM), hypertrophic (HCM), and restrictive (RCM). Maternal and fetal outcomes were identified using International Classification of Diseases, 9th and 10th Revision, Clinical Modification codes. Baseline characteristics and temporal trends of CDM subtypes were analyzed. Maternal cardiovascular, pregnancy, and fetal outcomes were evaluated by CDM subtype using univariate logistic regression. The primary outcome was in-hospital mortality.

RESULTS: During 2005-2020, 37,125 out of 61,811,842 delivery hospitalizations were complicated by CDM. Among CDM-related delivery hospitalizations, the most prevalent were DCM (46%), followed by PPCM (45.6%), HCM (4.6%), and RCM (3.9%). The rates of in-hospital mortality (1.7%), adverse cardiovascular events such as acute heart failure (17%), cardiogenic shock (3.4%), and cardiac arrest (3.1%), and adverse pregnancy outcomes such as preeclampsia (14.2%) and preterm labor (11%), were highest among PPCM (all p < 0.0001). The prevalence of PPCM (49.1% to 38.5%) decreased while the prevalence of HCM (2.7% to 8.8%) and DCM (48% to 52.2%) increased over time.

CONCLUSIONS: Over a 15-year period, PPCM had higher rates of in-hospital mortality, cardiovascular events, and adverse pregnancy outcomes compared to other CDM subtypes. While the prevalence of PPCM decreased over time, the prevalence of HCM and DCM increased. Hence, further research on cardiomyopathies during pregnancy and prospective studies on this vulnerable patient cohort are urgently needed.

First Page

102855

DOI

10.1016/j.cpcardiol.2024.102855

Volume

49

Issue

12

Publication Date

12-1-2024

Medical Subject Headings

Humans; Pregnancy; Female; United States (epidemiology); Pregnancy Complications, Cardiovascular (epidemiology, therapy); Adult; Hospitalization (statistics & numerical data, trends); Cardiomyopathies (epidemiology, therapy); Hospital Mortality (trends); Delivery, Obstetric (methods, statistics & numerical data); Pregnancy Outcome (epidemiology); Retrospective Studies; Prevalence; Young Adult; Databases, Factual

PubMed ID

39299364

Link to Full Text

Share

COinS