Cardiac Arrest During Delivery Hospitalization : A Cohort Study

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Critical Care Medicine

Background:

• Cardiac arrest during delivery is a critical event impacting maternal mortality.
• Understanding the incidence and outcomes of cardiac arrest during delivery hospitalizations is essential for developing targeted interventions.
• Estimates of cardiac arrest during delivery guide evidence-based strategies to reduce pregnancy-related deaths.

Purpose of the Study:

• To investigate the incidence of cardiac arrest during delivery hospitalizations.
• To identify maternal characteristics associated with cardiac arrest during delivery.
• To determine survival rates after cardiac arrest during delivery hospitalization.

Main Methods:

• Retrospective cohort study utilizing the National Inpatient Sample database from 2017 to 2019.
• Inclusion of delivery hospitalizations for women aged 12 to 55 years across U.S. acute care hospitals.
• Identification of cardiac arrest, medical conditions, and outcomes using ICD-10-CM codes; survival assessed by discharge disposition.

Main Results:

• The incidence of cardiac arrest was 13.4 per 100,000 delivery hospitalizations (approximately 1 in 7463).
• Overall survival to hospital discharge was 68.6%.
• Survival was lower in cases with co-occurring disseminated intravascular coagulation (DIC), particularly without transfusion (50.0%).

Conclusions:

• Cardiac arrest during delivery hospitalizations is a rare but significant event with a survival rate of nearly 7 in 10.
• Maternal characteristics such as older age, non-Hispanic Black race, and underlying medical conditions were associated with higher cardiac arrest rates.
• Disseminated intravascular coagulation (DIC) was identified as a complication associated with lower survival rates following cardiac arrest during delivery.