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Hospital admissions for aortic stenosis in pregnancy in the United States - a thirteen year analysis

Neiberg de Alcantara Lima1, Ricardo Lessa de Castro1, Cuyler Huffman2

  • 1Department of Internal Medicine - Western Michigan University Homer Stryker MD School of Medicine Kalamazoo, MI, USA.

American Journal of Cardiovascular Disease
|November 23, 2020
PubMed

Insights

Aortic stenosis (AS) in pregnancy is rare but associated with higher costs and increased risk of pulmonary hypertension and heart failure. Despite low mortality, awareness is crucial for managing this cardiac condition during pregnancy.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Public Health

Background:

  • Cardiac disease is a leading cause of maternal morbidity and mortality.
  • Valvular heart disease, particularly aortic stenosis (AS), poses significant risks during pregnancy.
  • AS is uncommon in younger populations but can lead to severe complications in pregnant women.

Purpose of the Study:

  • To investigate the incidence, outcomes, and costs associated with aortic stenosis in pregnant patients in the USA.
  • To identify complications and healthcare utilization patterns for AS during pregnancy.

Main Methods:

  • Retrospective review of the HCUP-NIS Database from 2002-2014.
  • Analysis of weighted discharges for pregnancy and AS diagnoses.
  • Examination of cardiac interventions, costs, and associated billing codes.

Main Results:

  • Low incidence of AS in pregnancy identified over the 13-year study period.
  • Patients with AS had significantly higher mean costs per discharge.
  • Increased billing codes for pulmonary hypertension and heart failure were observed; no deaths were reported in the AS group undergoing intervention.

Conclusions:

  • Aortic stenosis in pregnancy is rare but linked to increased healthcare costs and specific complications like pulmonary hypertension and heart failure.
  • While direct mortality in this cohort was low, heightened clinical awareness is essential due to potential risks and economic impact.
  • Further research into associated conditions like arrhythmias and ischemic heart disease in pregnant AS patients is warranted due to poor reporting.

Keywords:
Aortic valve stenosisUnited Statesepidemiologypregnancy

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