Background: During pregnancy, the hyperdynamic physiology of circulation can exacerbate many cardiovascular\ndisorders. Congestive heart failure (CHF) usually occurs during late pregnancy, which is significantly associated with\na high level of maternal and neonatal morbidities and mortalities. The profile of women who develop peripartum\nCHF (PCHF) is unknown. We investigated the epidemiological profiles of PCHF.\nMethods: In this retrospective cohort study, PCHF patients were identified using International Classification of\nDiseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in Taiwanââ?¬â?¢s National Health Insurance Research\nDatabase. Risk factors and obstetric outcomes were compared in women with and without PCHF.\nResults: From 2,115,873 birth-mothers in Taiwan between 1997 and 2013, we identified 512 with PCHF (incidence: 24.\n20/105). More women with than without PCHF were older (ââ?°Â¥ 35, 18.16% vs. 9.62%), and had more multifetal gestations\n(7.42% vs. 1.40%), gestational hypertension (HTN) (19.2% vs. 1.31%), and gestational diabetes mellitus (4.10% vs. 0.67%).\nAfter the analysis had been adjusted for confounders, the leading comorbidities associated with PCHF were\nstructural heart diseases (adjusted odds ratio [aOR]: 67.21; 95% confidence interval [CI]: 54.29ââ?¬â??83.22),\npulmonary diseases (aOR: 13.12; 95% CI: 10.28ââ?¬â??16.75), chronic HTN (aOR: 11.27; 95% CI: 6.94ââ?¬â??18.28), thyroid\ndisease (aOR: 9.53; 95% CI: 5.27ââ?¬â??17.23), and gestational HTN (aOR: 5.16; 95% CI: 3.89ââ?¬â??6.85). PCHF patients also\nhad a higher rate of cesarean sections (66.41% vs. 34.46%; p < 0.0001).\nConclusion: Maternal structural heart diseases, pulmonary diseases, thyroid disorders, and preexisting or\ngestational HTN are associated with a higher risk of developing PCHF. Birth-mothers with PCHF also had\na higher risk of caesarean section and adverse outcomes, including maternal death. Our findings should\nbenefit healthcare providers, and government and health insurance policy makers.
Loading....