Key result
Chronic hypertension linked to ~13-fold higher risk of CM at delivery.
Why the study?
Is chronic hypertension associated with the increasing prevalence of cardiomyopathy at delivery in pregnant women?
Is chronic hypertension associated with the increasing prevalence of cardiomyopathy at delivery in pregnant women?
The increasing prevalence of chronic hypertension among pregnant women is a major factor driving the rising rates of cardiomyopathy at delivery.
Chronic hypertension was associated with rising cardiomyopathy at delivery; leaves open whether BP control modifies risk pending prospective studies.
Objective Cardiomyopathy ( CM ) at delivery is increasing in prevalance. The objective of this study was to determine which medical conditions are attributable to this increasing prevalance. Design Population prevalence study from 2000 to 2009. Setting The Nationwide Inpatient Sample ( NIS ). Sample Pregnant women admitted for delivery were identified in the NIS for the years 2000–2009. Methods Temporal trends in pre‐existing medical conditions and in medical and obstetric complications at delivery admissions were determined by linear regression. The change in the prevalence of CM among all pregnant women was compared with the change in the prevalance of CM among pregnant women without pre‐existing conditions or complications. Main outcome measure Prevalence of CM . Results The prevalence of CM increased from 0.25 per 1000 deliveries in 2000 to 0.43 per 1000 deliveries in 2009 ( P < 0.0001). Women with chronic hypertension had increased odds of developing CM compared with women without chronic hypertension (odds ratio, OR , 13.2; 95% confidence interval, 95% CI , 12.5–13.7). The linear increase in chronic hypertension over the 10‐year period was the single identified pre‐existing medical condition that explained the increasing prevalence of CM at delivery ( P = 0.005 for the differences in slopes for linear trends). Conclusions Pregnant women with chronic hypertenion are at an increased risk for CM at delivery, and the increasing prevalence of chronic hypertension is an important factor associated with the increasing prevalence of CM at the time of delivery. Among women without chronic hypertension, the prevalence of CM at delivery did not change during the time period.
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Grotegut et al. (2014) studied this question. The prevalence of cardiomyopathy at delivery increased from 0.25 to 0.43 per 1000 deliveries, with chronic hypertension associated with an OR of 13.2 for developing CM.
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