Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study

Author:

Meng Marie-Louise12,Frere Zachary23,Fuller Matthew12,Li Yi-Ju3,Habib Ashraf S.12,Federspiel Jerome J.45,Wheeler Sarahn M.4,Gilner Jennifer B.4,Shah Svati H.67,Ohnuma Tetsu12,Raghunathan Karthik12,Krishnamoorthy Vijay12

Affiliation:

1. Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina

2. Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina

3. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina

4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina

5. Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, Baltimore, Maryland

6. Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina

7. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Abstract

BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute maternal cardiovascular morbidity events after delivery among patients with a diagnosis of preeclampsia versus those without this diagnosis. METHODS: In this retrospective cohort study, the Premier inpatient database was used to examine a cohort of obstetric patients older than 18 years, who delivered from January 1, 2016, to September 30, 2020. A diagnosis of preeclampsia and preeclampsia with severe features during delivery hospitalization were the exposures of interest. The primary outcome was a composite of maternal cardiovascular morbidity events during delivery hospital admission. The secondary outcome was the occurrence of maternal cardiovascular morbidity events during a readmission within 90 days of delivery hospitalization. RESULTS: In total, 4,488,759 patients met inclusion criteria, of which 158,114 (3.5%) were diagnosed with preeclampsia without severe features, and 117,940 (2.6%) with preeclampsia with severe features. Adjusted odds of maternal cardiovascular morbidity events were higher in patients with preeclampsia and in those with preeclampsia with severe features compared with those without preeclampsia during delivery hospitalization (adjusted odds ratio [OR] [95% confidence interval {CI}] 1.87 [1.78–1.97] and 4.74 [4.44–5.05], respectively) and within 90 days (adjusted OR [95% CI] 2.01 [1.83–2.21] and 2.32 [2.10–2.57], respectively). CONCLUSIONS: Patients with both preeclampsia and preeclampsia with severe features have higher rates of maternal cardiovascular morbidity events than those without preeclampsia. Future studies are necessary to examine which patients with preeclampsia are at highest risk for cardiovascular complications.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Anesthesiology and Pain Medicine

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