Maternal and Pregnancy Outcomes Following Heart Transplantation in the United States.
JACC Heart Fail
; 11(12): 1666-1674, 2023 12.
Article
em En
| MEDLINE
| ID: mdl-37804312
ABSTRACT
BACKGROUND:
Improved survival following heart transplantation (HT) has led to more recipients contemplating pregnancy, but data on outcomes are limited.OBJECTIVES:
The authors used a national data set to investigate and describe outcomes of pregnancies and deliveries in the United States in HT recipients.METHODS:
Diagnosis and procedure codes from the 2010-2020 Nationwide Readmissions Database identified delivery hospitalizations, history of HT, comorbid conditions, and outcomes. The authors compared rates of severe maternal morbidity (SMM), nontransfusion SMM, cardiovascular SMM (cSMM), and preterm birth from delivery hospitalization between HT recipients and no-HT recipients. The authors evaluated readmission to 330 days postpartum. Logistic and proportional hazard regressions were performed, adjusting for age, socioeconomic and facility characteristics, and clinical comorbidities.RESULTS:
Among 19,399,521 deliveries, 105 were HT recipients. Compared with no-HT, HT recipients were at higher risk for all SMM (24.8% vs 1.7%), nontransfusion SMM (20.8% vs 0.7%), cSMM (7.3% vs 0.12%), and preterm birth (43.3% vs 8.2%), all P < 0.001. In adjusted analyses, HT recipients had 16-fold greater odds of SMM, 28-fold greater odds of nontransfusion SMM, 38-fold greater odds of cSMM, and 7-fold greater odds of preterm birth. HT recipients had higher morbidity rates during delivery hospitalization and higher readmission rates within 1 year following delivery (26.9% vs 3.8%; adjusted HR 6.03 [95% CI 3.73-9.75]).CONCLUSIONS:
Delivery with history of HT is associated with significantly increased rates of SMM, preterm birth, and hospital readmission. These results provide data regarding pregnancy outcomes for use when counseling patients with HT history who are considering pregnancy or who are pregnant.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
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Transplante de Coração
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Nascimento Prematuro
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Insuficiência Cardíaca
Tipo de estudo:
Prognostic_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article