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Medical/Surgical/Diseases/Complications

Poster Session 3

(746) Peripartum Cardiomyopathy Delivery Hospitalization and Postpartum Readmission Trends, Risk Factors, and Outcomes

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

To evaluate prevalence of peripartum cardiomyopathy (PPCM) during birth and postpartum hospitalizations, and to analyze associated trends, risk factors, and clinical outcomes.

Study Design:

Birth hospitalizations and postpartum readmissions within 5 months of delivery were analyzed from the 2010-2020 Nationwide Readmissions Database. Temporal trends in PPCM diagnoses were analyzed with joinpoint regression to estimate the average annual percent change (AAPC) with 95% confidence intervals (CI). Clinical, demographic, and hospital factors associated with PPCM, and odds for severe adverse outcomes including mortality were assessed using adjusted logistic regression models with odds ratios (OR) as measures of effect.

Results:

Of 39.8 million birth hospitalizations, 9,210 were complicated by PPCM (2.3 per 10,000 birth hospitalizations). Prevalence of PPCM among 5-month readmissions was 4.8 per 10,000. PPCM prevalence during birth hospitalization increased from 2010 to 2020 (AAPC 2.2%, 95% CI 1.0%, 3.4%); prevalence of new PPCM diagnoses during readmissions did not (AAPC 0.0%, 95% CI -1.6%, 1.6%). Factors associated with peripartum cardiomyopathy (Table) include preeclampsia with severe features (aOR 13.9, 95% CI 12.5, 15.3), preeclampsia without severe features (aOR 6.0, 95% CI 5.3, 6.8), superimposed preeclampsia without severe features (aOR 10.2, 95% CI 8.5, 12.3), multiple gestation (aOR 2.7, 95% CI 2.3, 3.0), pre-gestational diabetes (aOR 1.8, 95% CI 1.6, 2.1), chronic hypertension (aOR 6.3, 95% CI 5.5, 7.2), and maternal age 40-54 years (aOR 1.9, 95% CI 1.7, 2.2, ref age 25-29). PPCM readmissions were associated with 10% of overall postpartum deaths, 21% of cardiac arrest/ventricular fibrillation diagnoses, 18% of extracorporeal membrane oxygenation cases, and 40% of cardiogenic shock cases.

Conclusion:

PPCM prevalence during birth hospitalizations has increased over time. Preeclampsia and maternal chronic conditions were associated with the highest odds of PPCM. PPCM accounts for a significant proportion of severe postpartum adverse cardiopulmonary outcomes and death.