The prevalence of pregnant women with heart disease rose by 24 percent over a 10-year period, according to a study, “National Trends and In-Hospital Outcomes in Pregnant Women With Heart Disease in the United States,” that appeared in the American Journal of Cardiology.
Researchers at New York’s Stony Brook University called for increased awareness of heart disease among women of childbearing age, as well as disease screening in pregnant women and a broader approach to labor and delivery.
Heart disease is the leading cause of death among pregnant women in the United States and other developed countries, but its prevalence and trends are not completely understood.
Using the Healthcare Cost and Utilization Project’s National Impatient Sample, researchers analyzed hospital admissions for delivery in pregnant women from 2003 to 2012. Included were about 81,000 women with heart disease and nearly 40 million without.
The analysis showed that congenital heart disease (CHD) was the most frequent disease subtype (41.8 percent), followed by valvular heart disease (30.9 percent), cardiomyopathy (20.8 percent) and pulmonary hypertension, or PH, with 6.5 percent.
Major adverse cardiac events such as in-hospital death, heart attack, heart failure, arrhythmia, stroke,or heart complications related to anesthesia were more frequent among women with cardiomyopathy (44 percent), but less frequent among those with CHD (6.2 percent). PH patients had the highest rate of in-hospital death (1 percent), followed by cardiomyopathy patients (0.7 percent).
Importantly, the study revealed that the prevalence of pregnant women with heart disease jumped by 24.7 percent from 2003 to 2012; the same period saw a corresponding rise in cardiomyopathy, CHD and PH cases. The frequency of major adverse cardiac events rose by 18.8 percent.
“We learned that in addition to the high and growing prevalence of women with heart disease delivering babies, the reasons are mainly related to increases in women delivering babies with diseases such as cardiomyopathy, adult congenital heart disease and pulmonary hypertension,” Dr. Kathleen Stergiopoulos, the study’s senior author, said in a press release.
Stergiopoulos said her findings should drive current clinical practices towards greater care for pregnant women with heart disease. Future strategies for the proper counseling of these patients should include an analysis of heart disease risk, a careful pregnancy follow-up,and a multi-disciplinary approach to labor and delivery carried out by a specialized team of doctors.
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