Abstract 11956: Obstetric and Cardiovascular Outcomes in Pregnant Women With Hypertrophic Cardiomyopathy: A Nationwide Cohort Study and a Propensity Score-Matched Analysis
IntroductionHypertrophic Cardiomyopathy (HCM) is not uncommon in women in reproductive age. Yet, there are limited data to aid in counseling patients and guiding practice.HypothesisWe sought to compare the obstetric and cardiovascular outcomes in pregnant women with HCM to those in healthy women.Met...
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| Published in: | Circulation (New York, N.Y.) Vol. 138; no. Suppl_1 Suppl 1; p. A11956 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
by the American College of Cardiology Foundation and the American Heart Association, Inc
06-11-2018
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| Online Access: | Get full text |
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| Summary: | IntroductionHypertrophic Cardiomyopathy (HCM) is not uncommon in women in reproductive age. Yet, there are limited data to aid in counseling patients and guiding practice.HypothesisWe sought to compare the obstetric and cardiovascular outcomes in pregnant women with HCM to those in healthy women.MethodsUsing ICD-9 codes in the Nationwide Readmission Databases (January 2010 through August 2015), we identified encounters of 1) pregnant women with HCM 2) healthy pregnant women without associated comorbidities. Primary outcomes were unmatched and matched obstetric (composite of pre-eclampsia, post-partum hemorrhage, and gestational hypertension) and cardiovascular (composite of in-hospital mortality, heart failure, acute myocardial infarction, and pulmonary embolism). Subsequently, HCM and health women were propensity score-matched by a ratio of 1:2.ResultsWe included 368 and 12,662,090 encounters for HCM and healthy pregnant women, respectively. Comparing those with HCM to healthy women controls, median age was 25 years (IQR 25, 34) vs 29 years (IQR 24, 32), length of stay was 3 days (IQR 2-3) vs 2 days (IQR 2-3), and prevalence of C-section was 45% as compared to 29% (all p<0.0001). HCM prevalent comorbidities were7% valve disease (mitral and tricuspid), 33% anemia, 10% obesity, and 5% diabetes mellitus. Obstetric outcomes in HCM vs healthy women occurred in 11% vs 8% (p=0.2) and cardiovascular outcomes occurred in 5.1% in HCM women vs 0.01% in health women(p<0.0001). 30-day readmission in HCM vs healthy women occurred in 5.1% vs 0.9% (p<0.0001). There were 0% fatalities during readmission in HCM group vs <0.001% in the healthy group at index admission and the 30-day readmission. 1:2 (HCM:healthy) propensity score matching results are shown in Table.ConclusionHCM in pregnant women is associated with increased risk of adverse cardiovascular outcomes during the index delivery admission and a higher risk of 30-day readmission without evidence of increased mortality as compared to pregnant healthy women. |
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| ISSN: | 0009-7322 1524-4539 |