학술논문
Abstract 13112: Cardiovascular Complications During Delivery Hospitalizations in Patients With Pulmonary Hypertension: A Nationwide Analysis
Document Type
Academic Journal
Author
Source
Circulation. Nov 07, 2023 148(Suppl_1 Suppl 1):A13112-A13112
Subject
Language
English
ISSN
0009-7322
Abstract
Introduction: Pregnancy in patients with pulmonary hypertension (PH) is associated with a high risk of medical complications. We aimed to study the patient characteristics and association between PH and delivery complications.Hypothesis: PH is associated with poor outcomes in pregnant patients.Methods: We utilized the National Inpatient Sample (NIS) database 2011-2020 to identify adult patients (≥18 years) with PH undergoing delivery hospitalizations. The primary outcomes were in-hospital medical and obstetric complications. Multivariate regression was performed to study the association of PH with these complications.Results: A total of 37,482,207 delivery hospitalizations were identified out of which 9,593 patients had PH. Pregnant patients with PH had a higher incidence of complications at delivery like preeclampsia/eclampsia, cardiac arrhythmias, pulmonary edema amongst others as well as a higher incidence of in-hospital mortality compared to those without PH (0.51% vs 0.007%). In adjusted analyses, PH was independently associated with a higher risk of pulmonary edema (Odds ratio (OR) 18.65 (95% confidence interval (CI) 13.71-25.38), p<0.001), peripartum cardiomyopathy (PPCM) (OR 14.06 (9.15-21.60), p<0.001), venous thromboembolism (VTE) (OR 12.25 (7.80-19.24), p<0.001), cardiac arrhythmias (OR 11.75 (10.11-13.67), p<0.001), acute kidney injury (AKI) (OR 7.53 (5.36-10.58), p<0.001), preeclampsia/eclampsia (OR 4.61 (4.04-5.25), p<0.001), and acute coronary syndrome (ACS) (OR 2.83 (1.17-6.85), p=0.02), compared with pregnant patients without PH. Further, stroke (OR 127.33 (78.49-206.57), p<0.001), AKI (OR 51.25 (34.40-76.36), p<0.001), cardiac arrhythmias (OR 24.80 (19.43-31.65), p<0.001), PPCM (OR 6.47 (3.23-12.97), p<0.001), pulmonary edema (OR 4.27 (2.18-8.37), p<0.001), VTE (OR 2.75 (1.07-7.10), p=0.036), and preeclampsia/eclampsia (OR 1.87 (1.35-2.60), p<0.001) were associated with a high risk of in-hospital mortality in pregnant patients with PH as compared to those without PH.Conclusions: Delivery hospitalizations in patients with PH are associated with worse outcomes. Prenatal counseling and multidisciplinary care are essential to help mitigate unfavorable outcomes in this cohort.