Boston Adult Congenital Heart Program, Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
Heart. 2012 Jan;98(2):145-51. doi: 10.1136/heartjnl-2011-300828. Epub 2011 Oct 11.
To define the epidemiology of adverse cardiovascular events among women with congenital heart disease (CHD) hospitalised for childbirth in the USA.
The 1998-2007 Nationwide Inpatient Sample, an administrative dataset representative of overall US hospital admissions, was used to identify hospitalisations for delivery.
Logistic regression was used to estimate ORs for cardiovascular outcomes (arrhythmia, heart failure, cerebrovascular accident, embolism, death or a combined outcome) for women with and without CHD. Covariates included age, number of medical comorbidities, pulmonary hypertension, hospital teaching status, insurance status and method of delivery.
Annual deliveries for women with CHD increased 34.9% from 1998 to 2007 compared with an increase of 21.3% in the general population. Women with CHD were more likely to sustain a cardiovascular event (4042/100,000 vs 278/100,000 deliveries, univariate OR 15.1, 95% CI 13.1 to 17.4, multivariable OR 8.4, 95% CI 7.0 to 10.0). Arrhythmia, the most common cardiovascular event, was more frequent among women with CHD (2637/100,000 vs 210/100,000, univariate OR 12.9, 95% CI 10.9 to 15.3, multivariable OR 8.3, 95% CI 6.7 to 10.1). Death occurred in 150/100,000 patients with CHD compared with 8.2/100,000 patients without CHD (multivariable OR 6.7, 95% CI 2.9 to 15.4). Complex CHD was associated with greater odds of having an adverse cardiovascular event than simple CHD (8158/100,000 vs 3166/100,000, multivariable OR 2.0, 95% CI 1.4 to 3.0).
Maternal CHD is associated with a markedly increased risk of adverse cardiovascular events and death during admission for delivery.
定义美国因分娩住院的先天性心脏病（CHD）女性不良心血管事件的流行病学。
使用 1998-2007 年全国住院患者样本，这是一个代表美国整体住院患者的行政数据集，来确定分娩住院的情况。
使用逻辑回归估计患有和不患有 CHD 的女性发生心血管结局（心律失常、心力衰竭、脑血管意外、栓塞、死亡或合并结局）的比值比（OR）。协变量包括年龄、合并症数量、肺动脉高压、医院教学地位、保险状况和分娩方式。
与普通人群中 21.3%的增长相比，1998 年至 2007 年，患有 CHD 的女性分娩量增加了 34.9%。患有 CHD 的女性更有可能发生心血管事件（4042/100000 与 278/100000 分娩，单变量 OR 15.1，95%CI 13.1 至 17.4，多变量 OR 8.4，95%CI 7.0 至 10.0）。心律失常是最常见的心血管事件，在患有 CHD 的女性中更为常见（2637/100000 与 210/100000，单变量 OR 12.9，95%CI 10.9 至 15.3，多变量 OR 8.3，95%CI 6.7 至 10.1）。在患有 CHD 的 150/100000 名患者中发生了死亡，而在没有 CHD 的 100000 名患者中只有 8.2/100000 名患者死亡（多变量 OR 6.7，95%CI 2.9 至 15.4）。与简单 CHD 相比，复杂 CHD 发生不良心血管事件的几率更高（8158/100000 与 3166/100000，多变量 OR 2.0，95%CI 1.4 至 3.0）。
母体 CHD 与分娩期间不良心血管事件和死亡的风险显著增加有关。
