Table 2.
Obstetric, cardiac, and other conditions associated with presence of congenital heart defects (CHD) in pregnancies* of privately-insured women aged 15–44, 2007–2014
| Type of Condition | No CHD (n=1,524,077) | CHD | Any: No CHD | Non-severe: No CHD | Severe: Non-severe | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Any (n=2,334) | Severe (n=352) | Non-severe (n=1,982) | ||||||||
| n (%) | n (%) | n (%) | n (%) | aPR | (95% CI) | aPR | (95% CI) | aPR | (95% CI) | |
| Obstetric Conditions† | ||||||||||
| Obstetric shock | 778 (0.1) | 5 (0.2) | NR | NR | 4.3 | (1.8–10.3) | 4.0 | (1.5–10.7) | ---‡ | |
| Transfusion | 8,709 (0.6) | 30 (1.3) | 5 (1.4) | 25 (1.3) | 2.2 | (1.5–3.2) | 2.2 | (1.5–3.3) | --- | |
| Placental abruption | 16,106 (1.1) | 40 (1.7) | 14 (4.0) | 26 (1.3) | 1.6 | (1.2–2.2) | 1.2 | (0.8–1.8) | 3.0 | (1.5–6.0) |
| Preterm labor/preterm birth | 240,736 (15.8) | 497 (21.3) | 96 (27.3) | 401 (20.2) | 1.4 | (1.3–1.6) | 1.3 | (1.2–1.5) | 1.5 | (1.1–1.9) |
| Infections | 63,954 (4.2) | 130 (5.6) | 17 (4.8) | 113 (5.7) | 1.3 | (1.1–1.6) | 1.4 | (1.1–1.6) | 0.8 | (0.4–1.3) |
| Placenta previa | 37,730 (2.5) | 74 (3.2) | 12 (3.4) | 62 (3.1) | 1.3 | (1.0–1.6) | 1.3 | (1.0–1.6) | --- | |
| Hemorrhage | 84,100 (5.5) | 168 (7.2) | 35 (9.9) | 133 (6.7) | 1.3 | (1.1–1.5) | 1.2 | (1.0–1.4) | 1.5 | (1.0–2.3) |
| Cardiac Conditions§ | ||||||||||
| Conduction disorders | 1,094 (0.1) | 101 (4.3) | 47 (13.4) | 54 (2.7) | 63.0 | (50.8–78.2) | 39.2 | (29.5–52.2) | 5.5 | (3.6–8.4) |
| VT, VF or SCA | 555 (0.0) | 28 (1.2) | 7 (2.0) | 21 (1.1) | 34.4 | (23.4–50.5) | 30.1 | (19.4–46.9) | --- | |
| Heart failure | 2,330 (0.2) | 47 (2.0) | 16 (4.6) | 31 (1.6) | 14.0 | (10.4–18.9) | 10.7 | (7.5–15.4) | 3.0 | (1.5–5.8) |
| Cardiomyopathy | 1,908 (0.1) | 36 (1.5) | 7 (2.0) | 29 (1.5) | 13.1 | (9.4–18.4) | 12.6 | (8.5–17.8) | --- | |
| Myocardial infarction | 264 (0.0) | 5 (0.2) | NR | NR | 12.5 | (5.1–30.2) | 14.3 | (5.9–34.7) | --- | |
| AF, AFL or SVT | 32,091 (2.1) | 355 (15.2) | 97 (27.6) | 258 (13.0) | 8.5 | (7.6–9.5) | 7.1 | (6.2–8.1) | 2.5 | (1.9–3.2) |
| Other Conditions|| | ||||||||||
| Pulmonary hypertension | 544 (0.0) | 45 (1.9) | 12 (3.4) | 33 (1.7) | 57.2 | (41.6–78.8) | 48.6 | (33.4–70.6) | 2.3 | (1.1–4.6) |
| Stroke or cerebrovascular disorders | 2,380 (0.2) | 85 (3.6) | 10 (2.8) | 75 (3.8) | 24.5 | (19.5–30.7) | 25.4 | (20.0–32.3) | 0.7 | (0.4–1.5) |
| Pulmonary edema | 794 (0.1) | 8 (0.3) | NR | NR | 6.9 | (3.4–13.8) | 7.0 | (3.3–14.8) | --- | |
| Pulmonary embolism | 2,092 (0.1) | 19 (0.8) | 7 (2.0) | 12 (0.6) | 5.9 | (3.7–9.4) | 4.3 | (2.4–7.8) | 3.5 | (1.3–8.9) |
| Acute respiratory distress syndrome | 2,051 (0.1) | 17 (0.7) | 6 (1.7) | 11 (0.6) | 5.6 | (3.5–9.0) | 4.2 | (2.3–7.6) | 3.0 | (1.1–8.3) |
| Deep vein thrombosis | 5,084 (0.3) | 36 (1.5) | NR | NR | 4.8 | (3.4–6.6) | 4.9 | (3.4–7.0) | --- | |
| Disseminated intravascular coagulation | 4,728 (0.3) | 24 (1.0) | NR | NR | 3.4 | (2.2–5.1) | 3.8 | (2.5–5.8) | --- | |
| Acute renal failure | 1,365 (0.1) | 6 (0.3) | NR | NR | 2.9 | (1.3–6.4) | 2.6 | (0.8–6.1) | --- | |
| Mechanical ventilation | 2,513 (0.2) | 9 (0.4) | NR | NR | 2.4 | (1.2–4.6) | 1.5 | (0.6–3.7) | --- | |
| Pulmonary disease | 45,692 (3.0) | 137 (5.9) | 26 (7.4) | 111 (5.6) | 2.0 | (1.7–2.4) | 1.9 | (1.6–2.3) | 1.3 | (0.8–2.1) |
| Thrombocytopenia | 18,783 (1.2) | 45 (1.9) | 10 (2.8) | 35 (1.8) | 1.6 | (1.2–2.2) | 1.4 | (1.0–2.0) | 1.8 | (0.9–3.8) |
| Anemia | 84,648 (5.6) | 160 (6.9) | 22 (6.3) | 138 (7.0) | 1.2 | (1.0–1.4) | 1.2 | (1.0–1.5) | 0.8 | (0.5–1.4) |
aPR: Prevalence ratio adjusted for age, region of residence and year at delivery; CI: Confidence interval; NR: not reported (N<5); AF: Atrial fibrillation; AFL: Atrial Flutter; SCA: Sudden cardiac arrest SVT: Supraventricular tachycardia; VT: Ventricular tachycardia; VF: Ventricular fibrillation.
Among pregnancies lasting >20 gestational weeks.
Obstetric conditions not associated with presence/severity of CHD included: gestational diabetes; hemorrhage; hysterectomy; infections including chorioamnionitis, endocarditis, endometritis, endomyometritis, metritis, pyelonephritis, or sepsis; maternal death during admission; placenta previa; and preeclampsia, eclampsia, and gestational hypertension.
For certain outcomes with low prevalence by CHD severity, the aPRs could not be calculated.
No women with CHD experienced coronary dissection during pregnancy.
No women experienced seizure disorders during pregnancy.