Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006
Article first published online: 22 NOV 2010
© 2010 RCOG No claim to original US government works Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 3, pages 345–352, February 2011
How to Cite
Kuklina, E. and Callaghan, W. (2011), Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 345–352. doi: 10.1111/j.1471-0528.2010.02743.x
- Issue published online: 12 JAN 2011
- Article first published online: 22 NOV 2010
- Accepted 15 August 2010. Published Online 22 November 2010.
- heart diseases;
Please cite this paper as: Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006. BJOG 2011;118:345–352.
Objectives To describe changes in characteristics of delivery and postpartum hospitalisations with chronic heart disease from 1995 to 2006.
Design Cross-sectional study.
Setting USA, nationwide hospital discharge data.
Population A total of 47 882 817 delivery hospitalisations and 660 038 postpartum hospitalisations.
Methods Adjusted odds ratios describing the associations between chronic maternal heart disease and severe obstetric complications were obtained from multivariable logistic models. The contribution of chronic heart disease to severe morbidity was estimated using adjusted population-attributable fractions.
Main outcome measures Prevalence and trends in chronic heart disease, rate and risk of severe obstetric complications.
Results In 2004–2006, about 1.4% of delivery hospitalisations were complicated with chronic heart disease. No substantial changes in the overall prevalence of chronic heart disease among hospitalisations for delivery were observed from 1995–1997 to 2004–2006. Even so, a linear increase was found for specific congenital heart disease, cardiac dysrhythmias, and cardiomyopathy and congestive heart failure (P < 0.01). During this same period the rate of postpartum hospitalisations with chronic heart disease tripled (P < 0.01). Severe complications during hospitalisations for delivery among women with chronic heart disease were more common in 2004–2006 than in 1995–1997. In 2004–2006, 64.5% of the cases of acute myocardial infarction, 57.5% of the instances of cardiac arrest/ventricular fibrillation, 27.8% of in-hospital mortality and 26.0% of the cases of adult respiratory distress syndrome were associated with hospitalisations with chronic heart disease.
Conclusions In the USA chronic heart disease among women hospitalised during pregnancy may have increased in severity from 1995 to 2006.