Real-world in-hospital outcomes and potential predictors of heart failure in primigravid women with heart disease in Southwestern China

Abstract

Background: Little is known about the status of maternal, obstetric, and neonatal complications and the potential predictors of developing heart failure (HF) in mothers with underlying heart disease (HD) in Southwestern China. Methods: The eligible records from the YiduCloud database from December 1, 2010 to December 31, 2019 were screened. The maternal clinical characteristics and the in-hospital outcomes were collected and compared in primigravid women with and without HD. The HD subtypes analyzed included valvular HD (VHD), cardiomyopathy, adult congenital HD (ACHD), pulmonary hypertension (PH), and other cardiac conditions. Results: Among 45,067 primigravid women, 508 (1.1%) had HD, in which 207 (41%) had ACHD, 66 (13%) had VHD, 84 (17%) had cardiomyopathy, 7 (1%) had PH, and 144 (28%) had other cardiac diseases. The maternal cardiac events and the neonatal complications occurred in 28% and 23.3%, respectively, of women with HD and were predominant in the PH group. In multivariable regression, HF was associated with the New York Heart Association (NYHA) class ≥3 (OR = 15.9, 95% confidence interval [CI] = 2.5-99.7; P = 0.003), heart rate ≥ 100 bpm (OR = 3.8, 95% CI = 1.1-13.5; P = 0.036), ejection fraction ≤60% (OR = 6.4, 95% CI = 2.0-21.0; P = 0.002) and left ventricular enddiastolic diameter ≥ 50 mm (OR = 3.4, 95% CI = 1.1-11.2; P = 0.041) at the beginning of pregnancy. Conclusions: Maternal and neonatal complications are higher in primigravid women with HD particularly in the PH group compared with primigravid women without HD. Women with HD should be guided on the potential predictors for HF and closely monitored during pregnancy to reduce maternal and neonatal complications.

Association of statin use and the risk of recurrent pulmonary embolism in real‐world Chinese population

“…A population-based, retrospective analysis was performed in collaboration with the Data Process and Application Platform (Yidu-Cloud (Beijing) Technology Co., Ltd., China). 16 , 17 De-identified patient information was collected from our University database, a platform of healthcare interoperability resources including data from seven hospitals and approximately more than 3 million patients' records (during 1 January 2017 to 31 December 2019). All patients diagnosed with PE were screened based on the appropriate codes of International Coding of Diseases (ICD, PE: ICD-10 [I26.x]) over the specified study period of 1 January 2017 to 31 December 2019.…”

“…A population‐based, retrospective analysis was performed in collaboration with the Data Process and Application Platform (Yidu‐Cloud (Beijing) Technology Co., Ltd., China) 16 , 17 . De‐identified patient information was collected from our University database, a platform of healthcare interoperability resources including data from seven hospitals and approximately more than 3 million patients' records (during 1 January 2017 to 31 December 2019).…”