Abstract 2260: Increased Risk of Pregnancy Induced Hypertension and Preeclampsia in Women With Coarctation of the Aorta
Introduction: Coarctation of the aorta (CoA), even after repair, is associated with systemic hypertension, abnormal vascular function and variably increased risk of cardiovascular events. Pregnancy induced hypertension (PIH) is a common pregnancy complication involving transient hypertension without or with (preeclampsia) proteinuria.
Hypothesis: We assessed the hypothesis that CoA increases risk for PIH and preeclampsia.
Methods: We used data from the 1998 –2006 Nationwide Inpatient Sample, a large nationally representative hospital discharge database, to produce US national estimates of patients with CoA hospitalized for childbirth. Patients were identified using ICD-9 procedure and diagnosis codes reflective of delivery and CoA (ICD-9: 747.10). Outcomes included length of stay (LOS), Cesarean section, PIH and preeclampsia.
Results: There were an estimated 605 (~1.6/100,000) deliveries in women with CoA between 1998 –2006 in the US. The incidence of deliveries in women with CoA increased over the study period (145, 210, 250 for 1998 –2000, 2001–2003, 2004 –2006 respectively, p=0.03 for trend). The mean age (27.2±0.6 v. 27.4±0.1 years, p=0.65) and number of comorbidities (0.20±0.04 v. 0.13±0.03, p=0.06) were comparable to the general population, but LOS was longer (3.1±0.2 v. 2.6±0.01 days, p=0.006) and there was a greater likelihood of Caesarean section. Those with CoA were more likely to have pre-existing (not pregnancy induced) hypertension, and had higher risk for PIH or preeclampsia (see Table⇓). The sample size precluded evaluation of eclampsia, as this occurred in only ~80/100,000 deliveries.
Conclusions: Maternal CoA is associated with increased risk of PIH and preeclampsia, as well as longer LOS and greater likelihood of Caesarean section.