Contemporary pregnancy outcomes for women with moderate and severe congenital heart disease

2021 ◽  
pp. 1753495X2110644
Author(s):  
Samantha A Kops ◽  
Danielle D Strah ◽  
Jennifer Andrews ◽  
Scott E Klewer ◽  
Michael D Seckeler

Background Women with congenital heart disease (CHD) are surviving into adulthood, with more undergoing pregnancy. Methods Retrospective review of the Vizient database from 2017–2019 for women 15–44 years old with moderate, severe or no CHD and vaginal delivery or caesarean section. Demographics, hospital outcomes and costs were compared. Results There were 2,469,117 admissions: 2,467,589 with no CHD, 1277 with moderate and 251 with severe CHD. Both CHD groups were younger than no CHD, there were fewer white race/ethnicity in the no CHD group and more women with Medicare in both CHD groups compared to no CHD. With increasing CHD severity there was an increase in length of stay, ICU admission rates and costs. There were also higher rates of complications, mortality and caesarean section in the CHD groups. Conclusion Pregnant women with CHD have more problematic pregnancies and understanding this impact is important to improve management and decrease healthcare utilization.

2020 ◽  
pp. 1-8
Author(s):  
Rohit S. Loomba ◽  
Jacqueline Rausa ◽  
Vincent Dorsey ◽  
Ronald A. Bronicki ◽  
Enrique G. Villarreal ◽  
...  

Abstract Introduction: Children with congenital heart disease and cardiomyopathy are a unique patient population. Different therapies continue to be introduced with large practice variability and questionable outcomes. The purpose of this study is to determine the impact of various medications on intensive care unit length of stay, total length of stay, billed charges, and mortality for admissions with congenital heart disease and cardiomyopathy. Materials and methods: We identified admissions of paediatric patients with cardiomyopathy using the Pediatric Health Information System database. The admissions were then separated into two groups: those with and without inpatient mortality. Univariate analyses were conducted between the groups and the significant variables were entered as independent variables into the regression analyses. Results: A total of 10,376 admissions were included these analyses. Of these, 904 (8.7%) experienced mortality. Comparing patients who experienced mortality with those who did not, there was increased rate of acute kidney injury with an odds ratio (OR) of 5.0 [95% confidence interval (CI) 4.3 to 5.8, p < 0.01], cardiac arrest with an OR 7.5 (95% CI 6.3 to 9.0, p < 0.01), and heart transplant with an OR 0.3 (95% CI 0.2 to 0.4, p < 0.01). The medical interventions with benefit for all endpoints after multivariate regression analyses in this cohort are methylprednisolone, captopril, enalapril, furosemide, and amlodipine. Conclusions: Diuretics, steroids, angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta blockers all appear to offer beneficial effects in paediatric cardiomyopathy admission outcomes. Specific agents within each group have varying effects.


2018 ◽  
Vol 9 ◽  
Author(s):  
Raymond Stegeman ◽  
Kaya D. Lamur ◽  
Agnes van den Hoogen ◽  
Johannes M. P. J. Breur ◽  
Floris Groenendaal ◽  
...  

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