Analysis of data from more than 50 million pregnancy-related hospitalizations shows that more needs to be done to identify new mothers at high risk for heart failure (HF) before they leave the hospital. Published in Circulation, the study showed that 60% of HF diagnoses associated with pregnancy occur during the postpartum period.
For the analysis, the researchers looked at data from the 2001 to 2011 Nationwide Inpatient Sample, the largest all-payer inpatient care database in the United States. Rates of HF were calculated by patient and hospital characteristics, and survey logistic regression was used to estimate odds ratios (Ors) representing the association between HF and each outcome, stratified by antepartum, delivery, and postpartum periods.
Overall, the rate of HF was 112 cases per 100,000 pregnancy-related hospitalizations. While nearly two-thirds of HF cases occurred postpartum, 27.3% were at delivery and 13.2% occurred antepartum. From 2001 to 2006, postpartum hospitalizations for HF increased annually by 7.1% (95% confidence interval [CI], 4.4 to 9.8) and the incidence was steady through 2011. From 2001 to 2011, HF rates during antepartum hospitalizations rose an average of 4.9% annually (95% CI, 3.0 to 6.8).
Adverse maternal outcomes were more likely in women diagnosed with HF, as reflected by outcome-specific ORs during the antepartum (2.7 to 25), delivery (6 to 195) and postpartum