Chad A Grotegut, Cary C Ward , Margaret G Jamison and Andra H James
Pre-existing Medical Conditions among Pregnant Women with Cardiomyopathy
Background: The purpose of this study was to identify medical conditions and obstetric complications associated with all forms of cardiomyopathy in pregnancy. Study Design: The Nationwide Inpatient Sample (NIS) for the years 2000-2007 was queried for all pregnancy-related discharges. The ICD-9 codes for cardiomyopathy were used to identify cases and were compared to women without cardiomyopathy. Results: During the 8-year period 2000-2007, there were 36,930 records with a diagnosis of cardiomyopathy in pregnancy for a rate of 0.98 per 1000 pregnancy-related discharges. At an admission for delivery, multivariable logistic regression demonstrated that chronic hypertension and preexisting heart disease were the pre-existing conditions that best predicted cardiomyopathy (OR 2.9, 95% CI 2.6, 3.3 for hypertension, OR 71.3, 95% CI 62.2, and 81.8 for pre-existing heart disease). Cardiac and pulmonary events that occurred during a delivery hospitalization were the two types of acute events most associated with cardiomyopathy in pregnancy (OR 34.7, 95% CI 28.8, 41.9 for cardiac event and OR 29.4, 95% CI 25.1, 34.4 for pulmonary events). Conclusions: Women with pre-existing cardiac disease and hypertension are at significantly increased risk for developing cardiomyopathy in pregnancy. Hypertension is a potentially modifiable risk factor that may ultimately decrease the risk for cardiomyopathy in pregnancy.
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