Abstract 19082: Cardiac Events and Mortality During Admissions for Delivery in Women with Congenital Heart Disease
Background: Labor, delivery, and the postpartum period are a time of increased arrhythmia and congestive heart failure (CHF) incidence. With improvements in the treatment of congenital heart disease (CHD), more women are reaching childbearing age and may be at increased risk for cardiac events and mortality during pregnancy and delivery.
Methods: The Healthcare Cost and Utilization Project was used to identify admissions for vaginal and cesarean delivery in California hospitals between 1/1/2005 and 12/31/2011. We compared length of stay, in-hospital mortality, incident CHF, cardiac arrest, and incident arrhythmias for women without CHD to women with non-complex CHD (NC-CHD) and complex CHD (C-CHD).
Results: We identified 2,720,980 deliveries resulting in 2,770,382 live births (74% of live births in the state over this period), which included 3,218 women with NC-CHD and 248 women with C-CHD. History of CHF was more common in women with CHD (8.1% for C-CHD, 2.6% for NC-CHD, and 0.08% for women without CHD, p<0.00005 for NC-CHD compared to no CHD and for C-CHD compared to no CHD). Those with CHD were more likely to undergo cesarean section (Table 1). Length of stay was significantly longer in women with CHD (2.6 ± 2.3 days for women without CHD, 3.4 ± 10.2 days for women with NC-CHD and 5.0 ± 13.3 days for women with C-CHD). In-hospital mortality was not significantly higher in women with CHD (Table 1). Incident heart failure, arrhythmias, and cardiac arrest were uncommon in all groups (Table 1).
Conclusions: In this study of 2.7 million women admitted to California hospitals for delivery, women with CHD were more likely to undergo cesarean section and had longer length of stay. Despite more frequent history of CHF in women with CHD, incident CHF and arrhythmias were rare during hospitalization. In-hospital mortality and cardiac arrest were not higher in CHD patients. These results suggest that in pregnant women with CHD, cardiac events and mortality at the time delivery are uncommon.
Author Disclosures: R.M. Hayward: None. E. Foster: Research Grant; Significant; Abbott Vascular. Z.H. Tseng: Research Grant; Significant; NIH/NHLBI 5R01 HL102090. Honoraria; Modest; Biotronik.
- © 2014 by American Heart Association, Inc.