Cardiovascular Complications During Delivery Hospitalizations in Patients With Infective Endocarditis

Infective endocarditis (IE) in pregnancy is a rare but serious infection that increases morbidity and mortality. We aimed to assess the risk factors and outcomes in pregnant patients with IE as compared to pregnancy without IE. The National Inpatient Sample was used to identify hospitalizations for delivery from 2011 to 2020. Propensity score matching was performed to study the association of IE with the primary outcomes of in-hospital medical and obstetric complications. A total of 37,482,206 weighted delivery hospitalizations in women ≥18 years were identified, of which 2020 patients had IE. Pregnant patients with IE had a higher incidence of complications during delivery, including in-hospital mortality, pre-eclampsia/eclampsia, peripartum cardiomyopathy, acute coronary syndrome, stroke, acute kidney injury, pulmonary edema, cardiac arrhythmias, and venous thromboembolism compared to those without IE. In propensity-matched analysis, IE was significantly associated with a higher risk of in-hospital mortality (odds ratio 16.50 [95% confidence interval 3.65 to 74.60], p <0.001), acute kidney injury (30.70 [11.00 to 86.00], p <0.001), stroke (18.00 [4.02 to 80.60], p <0.001), cardiac arrhythmias (4.67 [3.19 to 6.83], p <0.001), and venous thromboembolism (7.50 [2.35 to 23.90], p <0.001) compared to patients without IE. In conclusion, delivery hospitalizations in patients with IE are associated with a high risk of mortality and complications.