Abstract P1133: Higher Risk of Adverse Pregnancy Outcomes Among Black Women with Hypertrophic Cardiomyopathy Compared to White and Hispanic Women in The United States.

Abstract

Introduction: Pregnancy outcomes among women with hypertrophic cardiomyopathy (HCM) are not well described primarily due to small samples. The extent to which race/ethnicity influence pregnancy in this population Is not well studied. Hypothesis: We tested the hypothesis that among women with HCM, the risk of adverse outcomes during pregnancy and the puerperium will be higher among non-Hispanic Black and Hispanic compared to non-Hispanic White women. Methods: Data consisted of 18.1 million pregnancy-related hospitalizations among women aged 18 to 44 years, as recorded in the National Inpatient Sample from 2000-2021. Joinpoint regression was used to estimate annual percent changes (APC) in HCM trends. Logistic regression models were used to estimate the odds of adverse pregnancy outcomes (gestational diabetes, preeclampsia, fetal growth restriction, preterm birth, heart failure exacerbations and maternal mortality). Results: From 2000-2021, the prevalence of HCM among pregnant women increased by about 400% from 1.65 to 8.66 per 100,000. The increase differed by race/ethnicity (p=0.021): Black (APC: 11.4; 95%CI:8.8-16.8), Hispanic (APC: 7.6; 95%CI:4.2 -13.3) and White (APC: 7.3; 95%CI:5.2-9.9) (Figure). Among the women with HCM (n=591), Black women had higher odds for preeclampsia (Odds ratio [OR]=2.25; 95% confidence interval [CI]:1.17-4.33), gestational diabetes (OR=2.24; 95%CI:1.14-4.42), preeclampsia (OR=2.28; 95%CI:1.19-4.37), fetal growth restriction (OR=2.67; 95%CI:1.41-5.05), and heart failure (OR=4.06; 95%CI:1.71-9.67) compared to White women. Adjustment for sociodemographics, behavioral/lifestyle factors and chronic conditions prior to pregnancy attenuated these estimates but were mostly significant. Although maternal deaths were rare in this population, they all occurred among Black women. Conclusions: During the 21-year period, the prevalence of HCM among pregnant women increased the most among Black women, who also had higher risk of adverse pregnancy outcomes.