For a study, researchers sought to compare the rates of severe maternal morbidity (SMM) among pregnant patients with a cardiac diagnosis. Using diagnosis and procedure codes, this retrospective investigation used the 2015-2019 Nationwide Readmissions Database to identify hospitalizations, comorbidities, and outcomes. The key risk factor was the patient’s cardiac diagnosis, categorized as low-risk [modified World Health Organization (mWHO) classes I and II] or moderate-to-high-risk (mWHO classes II/III, III, or IV). Primary outcomes were cardiac-specific SMM during delivery hospitalizations and readmissions following delivery hospitalizations. The main result was SMM or death during the delivery hospitalization. Secondary outcomes included cardiac-specific SMM during delivery hospitalizations. There was a weighted national estimate of 14,995,122 delivery admissions, of which 46,541 (0.31%) had mWHO I-II diagnoses, and 37,330 (0.25%) had mWHO II/III-IV diagnoses. Patients with mWHO II/III-IV diagnoses had the highest rates of SMM occurrence (22.8% versus 1.6% for patients with no diagnosis, with an adjusted relative risk (aRR) of 5.67 [95% CI: 5.36-6.00]). The risk of death was likewise higher for patients with mWHO II/III-IV diagnoses (0.3% vs. 0.1% for patients with no diagnosis; adjusted relative risk (aRR): 18.07 [95% CI: 12.25-26.66]). Patients with an mWHO II/III-IV diagnosis continued to have an increased risk of SMM and death up until 11 months after giving birth. According to the classification used by the mWHO in this country-wide database, the prevalence of SMM was higher among people with moderate-to-severe cardiac illness. During the first postpartum year, this risk would still be present. These outcomes could be utilized in several ways to improve pregnancy counseling.
Source – sciencedirect.com/science/article/abs/pii/S0002870322000849
