Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted..
OBJECTIVE: Women with pregnancies complicated by hypertensive disorders of pregnancy (HDP) have increased long-term cardiovascular (CV) risk. We sought to determine if they demonstrate increased short-term CV risk.
METHODS: Using administrative records, all hospital-based deliveries in Florida from 2004 to 2010 and subsequent readmission to any Florida hospital within 3 years of index delivery were identified. Deliveries and clinical diagnoses were determined using International Classification of Diseases, Ninth Revision, Clinical Modification codes. HDP included pregnancies complicated by gestational hypertension, pre-eclampsia or eclampsia. Outcomes were CV readmission (acute myocardial infarction, stroke or heart failure), non-CV readmission and any readmission within 3 years of delivery excluding subsequent deliveries. Associations were determined using multivariate logistic regression.
RESULTS: Among 1 452 926 records from delivering mothers of singleton infants (mean age 27.2±6.2 years; 52% white, 23% African American (AA), 18% Hispanic), there were 4054 CV and 259 252 non-CV readmissions. Women with HDP had higher CV readmission rates (6.4 vs 2.5/1000 deliveries; P<0.001). AA women had higher rates of CV readmission than whites or Hispanics (6.8 vs 1.7 vs 1.0/1000 deliveries, respectively; P<0.001). Women with HDP had higher multivariate risk of CV readmission (OR 2.41; 95% CI 2.08 to 2.80) and any readmission (OR 1.13; 95% CI 1.10 to 1.15). Compared with whites, AA women had higher risk for CV readmission (OR 3.60; 95% CI 3.32 to 3.90) after adjustment for HDP.
CONCLUSION: Women with HDP had twice the risk of CV readmission within 3 years of delivery, with higher rates among AA women. More work is needed to explore preventive strategies for HDP-associated events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:104 |
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| Enthalten in: |
Heart (British Cardiac Society) - 104(2018), 14 vom: 11. Juli, Seite 1187-1194 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jarvie, Jennifer L [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiac risk factors and prevention |
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| Anmerkungen: |
Date Completed 31.01.2019 Date Revised 13.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/heartjnl-2017-312299 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM279885881 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. | ||
| 520 | |a OBJECTIVE: Women with pregnancies complicated by hypertensive disorders of pregnancy (HDP) have increased long-term cardiovascular (CV) risk. We sought to determine if they demonstrate increased short-term CV risk | ||
| 520 | |a METHODS: Using administrative records, all hospital-based deliveries in Florida from 2004 to 2010 and subsequent readmission to any Florida hospital within 3 years of index delivery were identified. Deliveries and clinical diagnoses were determined using International Classification of Diseases, Ninth Revision, Clinical Modification codes. HDP included pregnancies complicated by gestational hypertension, pre-eclampsia or eclampsia. Outcomes were CV readmission (acute myocardial infarction, stroke or heart failure), non-CV readmission and any readmission within 3 years of delivery excluding subsequent deliveries. Associations were determined using multivariate logistic regression | ||
| 520 | |a RESULTS: Among 1 452 926 records from delivering mothers of singleton infants (mean age 27.2±6.2 years; 52% white, 23% African American (AA), 18% Hispanic), there were 4054 CV and 259 252 non-CV readmissions. Women with HDP had higher CV readmission rates (6.4 vs 2.5/1000 deliveries; P<0.001). AA women had higher rates of CV readmission than whites or Hispanics (6.8 vs 1.7 vs 1.0/1000 deliveries, respectively; P<0.001). Women with HDP had higher multivariate risk of CV readmission (OR 2.41; 95% CI 2.08 to 2.80) and any readmission (OR 1.13; 95% CI 1.10 to 1.15). Compared with whites, AA women had higher risk for CV readmission (OR 3.60; 95% CI 3.32 to 3.90) after adjustment for HDP | ||
| 520 | |a CONCLUSION: Women with HDP had twice the risk of CV readmission within 3 years of delivery, with higher rates among AA women. More work is needed to explore preventive strategies for HDP-associated events | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a cardiac risk factors and prevention | |
| 650 | 4 | |a heart disease | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a pregnancy | |
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| 700 | 1 | |a Davis, Melinda B |e verfasserin |4 aut | |
| 700 | 1 | |a Ehrig, Jessica C |e verfasserin |4 aut | |
| 700 | 1 | |a Kao, David P |e verfasserin |4 aut | |
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