Abstract 14607: Pregnancy and Long-Term Heart Failure Risk in Women With Congenital Heart Disease
Introduction: There are limited data on long-term risk for heart failure (HF) after pregnancy in women with congenital heart disease (CHD).
Hypothesis: We hypothesized that type of CHD would be associated with long-term risk for HF in pregnant women with CHD.
Methods: We extracted 20-year (1996-2016) data for women who received CHD services (based on ICD9-CM codes 745-747) in our institution between 2008 and 2014 (cohort inception ). Pregnancy was identified through ICD9-CM codes 630-679, V22-24, V27-28, and V91. The earliest occurrence of a pregnancy-associated service was considered as baseline. We defined HF as ICD9-CM codes 428, 402.X1, 404.X1, and 404.X3 (Medicare definition). Incident HF was defined as new HF-associated services after baseline. We followed a modified Marelli classification for CHD severity.
Results: We identified 667 women with CHD who received pregnancy-associated services. Of these, 118 (17.9%) received HF-associated services before receiving any pregnancy-associated service and were deemed to have HF at baseline. Among the 549 women without HF at baseline, followup data were available in 534 (97.3%). Table 1 summarizes their characteristics. Of these, 108 received new HF-related services over a median of 4.9 (2.2-8.2) years. Risk for HF decelerated after 1 year but remained elevated (Fig. 1). By 5 years, 18.4% of women received HF-related services. Women with severe CHD were at highest risk (5-year risk 45.6%), followed by valvular (28.2%), shunts (27.5%), and other (21.4%) abnormalities.
Conclusions: Approximately 1 out of 5 of women with CHD will develop HF within 5 years after a 1st pregnancy. Risk is highest in the 1st year but remains elevated afterwards.
Author Disclosures: A.P. Kalogeropoulos: None. A. Saraf: None. T. Hoffman: None. C. Raskind-Hood: None. F.H. Rodriguez: None. C.J. Hogue: None. W.M. Book: None.
- © 2016 by American Heart Association, Inc.